Individual provider Active NPI

Dee Ann Lloyd Widder, LCSW

  • Clinical Social Worker
  • Dover, DE
National Provider Identifier
1346527967
Registry record updated Dec 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
Q1-0001116 Issued in DE
Practice address
156 S State St
Dover, DE 19901-7314
Phone
(302) 674-2380
Fax
(302) 674-1299
NPI assigned
Nov 10, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Q1-0001116 DE Primary

Addresses

Primary practice location

156 S State St
Dover, DE 19901-7314

Mailing address

156 S State St
Dover, DE 19901-7314
Phone (302) 674-2380

Other identifiers 1

IdentifierTypeStateIssuer
1346527967MedicaidDE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20140722000095 DE Practitioner - Clinical Social Worker 3072739416 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psychological Services P.a.Group PAC ID 1557690351, 7 clinicians

Practice addresses (Care Compare)

850 Library Ave
Suite 104
Newark, DE 19711-7170
Phone (215) 764-2403

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
Q1-0001116DEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological Services P.a. CurrentSince Aug 26, 2021 Accepting new patients
The Mind and Body Consortium, LLC. Clinical CurrentSince Jan 1, 2016 Accepting new patients

Locations

156 S State St
Dover, DE 19901
Phone 30267423801218

118 Sandhill Dr
Ste 201
Middletown, DE 19709
Phone 3024499314108

850 Library Ave
Ste 104
Newark, DE 19711
Phone (215) 764-2403

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1320883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449532800000",
    "number": "1346527967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "156 S STATE ST",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199017314",
            "telephone_number": "302-674-2380",
            "fax_number": "302-674-1299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 S STATE ST",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199017314",
            "telephone_number": "302-674-2380",
            "fax_number": "302-674-1299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDDER",
        "first_name": "DEE ANN",
        "middle_name": "LLOYD",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-10",
        "last_updated": "2015-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DE",
            "license": "Q1-0001116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1346527967",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, DE

Sources for this page

Verify at the official NPI Registry.