Healthcare Provider Details

I. General information

NPI: 1932893658
Provider Name (Legal Business Name): BRIGIT WINGERT MSW, LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2023
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2270 FORD PKWY STE 106
SAINT PAUL MN
55116-3412
US

IV. Provider business mailing address

4826 CHICAGO AVE STE 105
MINNEAPOLIS MN
55417-1055
US

V. Phone/Fax

Practice location:
  • Phone: 612-915-0049
  • Fax:
Mailing address:
  • Phone: 612-827-3028
  • Fax: 612-823-4993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number27782
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: