NPI 1104785872

Jessica Widboom, MSWLICSW

Practitioner Clinical Social Worker New Brighton, MN

Practice location

Address: 900 Long Lake Rd STE 360, New Brighton, MN 55112-6428
Phone: (612) 900-0233

Registered specialties

Clinical Social Worker Primary

Behavioral Health & Social Service Providers Taxonomy 1041C0700X Licence 31134 (MN)

Other Social Worker providers in Minnesota →

Registry record

NPI: 1104785872
Entity type: Individual
Sex (as registered): Female
NPI issued: 19 Jan 2026
Record last updated: 19 Jan 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.