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General NPI Number Information
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NPI Number | 1881084762
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Entity Type | Organization
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Legal Business Name | WELLS COUNTY SOCIAL SERVICES
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Dates
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Enumeration Date | 01/29/2015
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Last Update Date | 01/29/2015
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Provider Practice Location Address
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Address Line | 600 RAILWAY ST N #266
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City | FESSENDEN
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State | ND
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Zip | 58438-7426
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Country | US
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Telephone | 701-547-3694
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Fax | 701-547-3348
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Provider Business Mailing Address
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Address Line | 600 RAILWAY ST N #266
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City | FESSENDEN
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State | ND
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Zip | 58438-7426
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Country | US
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Telephone | 701-547-3694
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Fax | 701-547-3348
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. CARRIE THOMPSON-WIDMER
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Credential | LCSW
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Telephone | 701-547-3694
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 4938
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License Number State | ND
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