Jessica Widboom, MSW, LICSW
NPI 1104785872 · Clinical Social Worker · New Brighton, MN
Enrolled with Medicare as Practitioner - Clinical Social Worker · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Jessica Widboom, MSW, LICSW is a Clinical Social Worker provider in New Brighton, MN (NPI 1104785872).
Provider details
- NPI number
- 1104785872
- Entity type
- Individual
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Credential
- MSW, LICSW
- Sex
- Female
- Sole proprietor
- No
- License
- 31134 (MN)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2026-01-19
- Last updated
- 2026-01-19
- Certified
- 2026-01-19
Frequently asked questions
- What is Jessica Widboom's NPI number?
- Jessica Widboom's National Provider Identifier (NPI) is 1104785872, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Jessica Widboom's specialty?
- Jessica Widboom is listed in the NPPES registry with a primary specialty of Clinical Social Worker (Behavioral Health & Social Service Providers).
- Where is Jessica Widboom located?
- Jessica Widboom's practice location on file with NPPES is 900 Long Lake Rd Ste 360, New Brighton, MN 55112-6428.
- What is Jessica Widboom's phone number?
- The practice phone number listed in the NPPES registry for Jessica Widboom is (612) 900-0233.
- Does Jessica Widboom accept Medicare?
- Jessica Widboom is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Jessica Widboom's NPI active?
- Yes — Jessica Widboom's NPI (1104785872) is active in the NPPES registry as of the last update on 2026-01-19.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.