Individual
MS. PENNY DAWN WEDIN-GORDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW,LAC
Contact information
Practice address
1237 W DIVIDE AVE, STE 5, BISMARCK, ND 58501-1290
(701) 328-8832
(701) 328-8900
Mailing address
1237 W DIVIDE AVE, STE 5, BISMARCK, ND 58501-1290
(701) 328-8832
(701) 328-8900
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1526
ND
1041C0700X
Clinical Social Worker
2031
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021925
BCBS OF ND PIN
—
01
—
N21925
RR MEDICARE PIN
—
Enumeration date
06/12/2006
Last updated
04/12/2026
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