Mary Lynn Widseth, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

2100 Issued in MN

Practice address

2700 1St St N # 204
Saint Cloud, MN 56303-4256

Phone

(320) 250-7997

NPI assigned

Sep 10, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1568073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568073600000",
    "number": "1669021895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "828 22ND AVE N",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563032503",
            "telephone_number": "320-250-7997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 1ST ST N # 204",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563034256",
            "telephone_number": "320-250-7997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDSETH",
        "first_name": "MARY",
        "middle_name": "LYNN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-10",
        "last_updated": "2019-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "2100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca White, NP-C
• Summer L White
• Mary Kay Whorton, PA-C
• Jeffrey Wick, RPH
• Mary C Wiczek, APRN,CNP
• Nikki Rae Wieberdink
• Jaclyn M Wiechmann, RN
• Aimee N Wieland, PHARM.D.
• Christopher William Wieland, MD
• Dana Wieme, DPT

• Mental Health Counselor in Saint Cloud, MN
• Providers in Saint Cloud, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2019; 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.