Individual provider Active NPI

Carrie Lynn Thompson Widmer, LCSW

  • Clinical Social Worker
  • Turtle Lake, ND
National Provider Identifier
1124450556
Registry record updated Oct 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4938 Issued in ND
Practice address
416 Kundert St
Turtle Lake, ND 58575-4205
Phone
(701) 448-9225
Fax
(701) 448-2056
NPI assigned
Aug 8, 2013
Last updated
Oct 27, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 4938 ND Primary
Clinical Social Worker 1041C0700X 111053 TX

Addresses

Primary practice location

416 Kundert St
Turtle Lake, ND 58575-4205

Mailing address

416 Kundert St
Turtle Lake, ND 58575-4205
Phone (701) 448-9225

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230710002384 ND Practitioner - Clinical Social Worker 5890154728 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Northland Health Centers CurrentSince May 8, 2023 Accepting new patients
Northland Health Centers Current Accepting new patients
Northland Health Centers CurrentSince May 8, 2023 Accepting new patients

Locations

122 2nd St E
McClusky, ND 58463
Phone (701) 363-2296

416 Kundert St
Turtle Lake, ND 58575
Phone (701) 448-2331

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1375920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1793059200000",
    "number": "1124450556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 KUNDERT ST",
            "city": "TURTLE LAKE",
            "state": "ND",
            "postal_code": "585754205",
            "telephone_number": "701-448-9225",
            "fax_number": "701-448-2056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 KUNDERT ST",
            "city": "TURTLE LAKE",
            "state": "ND",
            "postal_code": "585754205",
            "telephone_number": "701-448-9225",
            "fax_number": "701-448-2056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON WIDMER",
        "first_name": "CARRIE",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-08",
        "last_updated": "2026-10-27",
        "certification_date": "2026-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ND",
            "license": "4938",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "111053",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Turtle Lake, ND

Sources for this page

Verify at the official NPI Registry.