Russell P Widder, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

Q1-0000180 Issued in DE

Practice address

148 S Bradford St
Dover, DE 19904-7318

Phone

(302) 736-1820

Fax

(302) 736-5016

NPI assigned

Jul 9, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• A Center for Human Development LTD

  • Clinical Social Worker
  • Dover, DE
  • NPI 1174559918
  Authorized official Same address or phone

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1336172386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 EGRET LN",
            "city": "WYOMING",
            "state": "DE",
            "postal_code": "199344002",
            "telephone_number": "302-736-1820",
            "fax_number": "302-736-5016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 S BRADFORD ST",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199047318",
            "telephone_number": "302-736-1820",
            "fax_number": "302-736-5016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDDER",
        "first_name": "RUSSELL",
        "middle_name": "P",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-09",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DE",
            "license": "Q1-0000180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000643973",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rosemarie Anita White, PMHNP
• Kathryn Whitescarver, O.D.
• Hannah Whitham, RBT
• Kimberly Whitt, RN
• Dee Ann Lloyd Widder, LCSW
• Jillian Wiggins, LPCMH
• Courtney Wilczynski, D.O.
• Kevin Wiley
• Sarah Wilhite, M.S., CCC-SLP
• Charity Wilks

• Clinical Social Worker in Dover, DE
• Providers in Dover, DE by specialty
• Clinical Social Worker in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.