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Deanna Wilde , MSW, LICSW

Social Worker β€’ Willmar, MN

Active NPI 1053188425 Individual Practitioner Female Practitioner
Practice location in NPPES

1708 1st St S
Willmar, MN 562014228

Call 2189997750 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

1708 1st St S

Willmar, MN 562014228

Telephone 2189997750
Organization at the Same NPPES Address or Phone
Modern Mojo Facility NPI 1902344591

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2023

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Can order Medicare-covered services

CMS lists Deanna Wilde as eligible to order or refer Medicare Part B clinical laboratory and imaging services and durable medical equipment (DME) for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Willmar and Minnesota

4 active clinicians are listed under Social Worker with a practice address in Willmar, MN (1,021 in Minnesota).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2026-07-14
Social Worker Primary Specialty

NUCC Taxonomy Code: 104100000X

License # reported to NPPES MN 31957

A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Minnesota Board of Medical Practice.
Look Up on State Board Site

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid ID
1003042656 (MN)

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Not Eligible
Power Mobility Devices (PMD) Not Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

2 listed
Ellen Cochran , APRN

Nurse Practitioner - Psychiatric/Mental Health

NPI 1750115036

Advanced Practice Registered Nurse

Lisa Thielke , APRN, CNP, PMHNP-BC

Nurse Practitioner - Psychiatric/Mental Health

NPI 1699461095

Advanced Practice Registered Nurse, Certified Nurse Practitioner, Psychiatric-Mental Health Nurse Practitioner (Board Certified)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

9 Historical Events
πŸ“
Updated Practice Location July 14, 2026

Registered at 1708 1ST ST S, WILLMAR, MN 562014228 (Tel: 2189997750)

πŸ“
Updated Business Mailing Address July 14, 2026

Registered at 1708 1ST ST S, WILLMAR, MN 562014228 (Tel: 2189997750)

πŸ‘€
Provider Name / Credentials Updated July 14, 2026

Recorded as DEANNA WILDE, MSW, LICSW

βœ…
NPI Profile Active December 06, 2023

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) December 06, 2023

Registered at 328 3RD ST SW, WILLMAR, MN 562013475 (Tel: 3202319763)

πŸ“
Business Mailing Address (Initial Record) December 06, 2023

Registered at 328 3RD ST SW, WILLMAR, MN 562013475 (Tel: 3202319763)

πŸ‘€
Provider Name / Credentials (Initial Record) December 06, 2023

Recorded as DEANNA WILDE, LGSW, ADC-T

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) December 06, 2023

Social Worker (license number reported to NPPES: MN 31957)

🟒
Initial NPI Registration & Enumeration December 06, 2023

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1053188425
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 06, 2023
Last Update: July 14, 2026
Sole Proprietor: Yes

Mailing Address

1708 1st St S

Willmar, MN 562014228

Phone: 2189997750

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.