Provider Demographics
NPI:1689817751
Name:WIDNER, DEONNE MARGARET (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:DEONNE
Middle Name:MARGARET
Last Name:WIDNER
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 4TH ST NW STE 115
Mailing Address - Street 2:
Mailing Address - City:BEMIDJI
Mailing Address - State:MN
Mailing Address - Zip Code:56601-3155
Mailing Address - Country:US
Mailing Address - Phone:218-214-9389
Mailing Address - Fax:218-517-2034
Practice Address - Street 1:403 4TH ST NW STE 115
Practice Address - Street 2:
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601-3155
Practice Address - Country:US
Practice Address - Phone:218-214-9389
Practice Address - Fax:218-517-2034
Is Sole Proprietor?:No
Enumeration Date:2009-04-19
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN194391041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty