I Am Incorporated
Organization Active NPI Clinical Social Worker · Cass Lake, MN
NPI 1215601422 · NPPES record last updated Jul 23, 2025
Key facts
- NPI
- 1215601422
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Social Worker 1041C0700X
- Legal business name
- I AM INCORPORATED
- Practice address
- 19781 Mission Road SE
Cass Lake, MN 56633 - Phone
- (218) 214-9389
- Fax
- (218) 517-2034
- NPI assigned
- Aug 3, 2021
- Organization subpart
- No
Authorized official
- Name
- Deonne M. Widner, LICSW
- Title
- Cfo
- Phone
- (218) 214-9389
Practitioners 5
-
Jeffrey Scott Widner, LICSW
-
Deonne Margaret Widner, MSW, LICSW
-
Candace Snodgrass, PHD
-
Charles-Camarin Widner, MSW, LGSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220902001421 | MN | Part B Supplier - Clinic/Group Practice | 2365826740 |
Receives reassigned benefits from 2 practitioners Practice locations: Bemidji, MN |
National Provider Directory
Locations
403 4th St NW
Ste 115
Bemidji, MN 56601
Phone (218) 214-9389
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker |
1041C0700X | Yes |
Addresses
Primary practice location
19781 Mission Road SE
Cass Lake, MN 56633
Mailing address
403 4TH St NW Ste 115
Bemidji, MN 56601-3155
Phone (218) 214-9389
Other practice location 1
403 4th St NW Ste 115
Bemidji, MN 56601-3155
Phone (218) 214-9389
Other providers in Cass Lake, MN
- Steve Higgins
- Robin Holmstrom
- Home Free Care, LLC
- Brian Hudson
- Uyen Nhu Huynh
- Colton Iverson
- Robert Jaspers
- Kari Lynn Johnson
- Lois Johnson
- Nickalette Johnson
All providers in Cass Lake, MN · Clinical Social Worker in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 23, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.