MS. PENNY DAWN WEDIN-GORDEN LICSWLAC NPI 1093757205

NPI Information

NPI: 1093757205
Provider Name: MS. PENNY DAWN WEDIN-GORDEN, LICSW,LAC
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
1237 W DIVIDE AVE
STE 5
BISMARCK, ND
ZIP 58501
Phone: (701) 328-8832
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MS. Penny Dawn Wedin-gorden, LICSW,LAC is an addiction (substance use disorder) counselor in Bismarck, ND. MS. Penny Dawn Wedin-gorden, LICSW,LAC NPI is 1093757205. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1237 W DIVIDE AVE
STE 5
BISMARCK, ND
ZIP 58501-290
Phone: (701) 328-8832
Fax: (701) 328-8900

The enumeration date for this NPI number is 6/12/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	1526	NORTH DAKOTA	Yes
2	1041C0700X	Social Worker	Clinical	2031	NORTH DAKOTA	X

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier Issuer
1	021925	OTHER	BCBS OF ND PIN
2	N21925	OTHER	RR MEDICARE PIN
3	N21925	MEDICARE ID-TYPE UNSPECIFIED

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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