Individual provider · Type 1 NPI
Jessica Widboom, MSW, LICSW
Clinical Social Worker · New Brighton, MN
Practice location
900 Long Lake Rd Ste 360
New Brighton, MN 55112-6428
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Clinical Social Worker Primary | 1041C0700X | 31134 (MN) |
Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…
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About NPI 1104785872
Jessica Widboom, MSW, LICSW's National Provider Identifier is 1104785872, issued on Jan 19, 2026. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in New Brighton, MN. The record was last updated on Jan 19, 2026.