Wedin-Gorden, Penny Dawn
Wedin-Gorden, Penny Dawn is an individual health care provider with primary practice located at 1237 W Divide Ave Ste 5, Bismarck ND 58501-1290. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is her primary health care specialty. Wedin-Gorden, Penny Dawn can be contacted via phone (701) 328-8832.Contact Information
Primary practice address
1237 W Divide Ave Ste 5
Bismarck ND 58501-1290
Phone: (701) 328-8832
Fax: (701) 328-8900
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 1526 | North Dakota |
Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 2031 | North Dakota |
Profile Details
NPI number | 1093757205 |
---|---|
LBN Legal business name | Wedin-Gorden, Penny Dawn |
Credentials | LICSW,LAC |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 12th, 2006 |
Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1093757205 | NPPES |
Other | N21925 | RR MEDICARE PIN | |
Other | 021925 | RR MEDICARE PIN |
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