CANDICE NICOLE DIENBERG (NPI# 1376968073) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376968073 |
| Entity Type | Individual |
| Full Name | CANDICE NICOLE DIENBERG |
| Credential | LCSW, SAC |
| Practice Address |
6510 Grand Teton Plz Ste 402 Madison WI 53719-1029 |
| Practice Telephone | 8554584966 |
| Practice Fax Number | 6088411200 |
| Mailing Telephone | 8554584966 |
| Mailing Fax Number | 6088411200 |
| Enumeration Date | 2014-03-04 |
| Last Update Date | 2020-10-30 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
15826-131 | WI | Behavioral Health & Social Service Providers |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
9228-123 | WI | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1015 Gammon Ln, Madison, WI 537192210 | 6084178144 |
| Street Address |
6510 GRAND TETON PLZ STE 402 |
| City | MADISON |
| State | WI |
| Zip Code | 53719-1029 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356997969 | Alexis Unser | Counselor | 6510 Grand Teton Plz Ste 402, Madison, WI 53719-1029 | 2019-08-11 |
| 1164999272 | Madison M Mayer | Social Worker | 6510 Grand Teton Plz Ste 402, Madison, WI 53719-1029 | 2018-10-26 |
| 1851758312 | Kristine A. Oliver | Marriage & Family Therapist | 6510 Grand Teton Plz Ste 402, Madison, WI 53719-1029 | 2016-01-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689271801 | Jessica Seidel | Registered Nurse | 1015 Gammon Lane, Madison, WI 53719 | 2020-10-01 |
| 1376168989 | 360 Wellness LLC | Physical Therapist | 504 S Yellowstone Lane, Madison, WI 53719 | 2020-06-09 |
| 1932744067 | Sara Ruiz | Marriage & Family Therapist | Clock Tower Office Park, 6333 Odana Rd, #20, Madison, WI 53719 | 2019-11-13 |
| 1700436466 | David R. Gosling | Counselor | 702 South High Point Road #209, Madison, WI 53719 | 2019-09-16 |
| 1285289587 | Clifton Leo Davis Jr. | Counselor | 6417 O Dana Rd #5, Madison, WI 53719 | 2019-08-05 |
| 1679127278 | Akillah Jamillah Wali | Psychologist | 6417 Odana Rd Suite 5, Madison, WI 53719 | 2019-07-31 |
| 1689230211 | Brandy Georgecopeland | Marriage & Family Therapist | 6417 Odana Rd. Ste 5, Madison, WI 53719 | 2019-05-20 |
| 1275016826 | Kelsey Andersen | Physical Therapist | 504 S. Yellowstone Lane, Madison, WI 53719 | 2018-09-10 |
| 1740797190 | Catelyn Schwerke | Social Worker | 3848 Maple Grove Dr, Apt 307, Madison, WI 53719 | 2018-01-08 |
| 1922519008 | Mary Jane Cruz Delorme | Registered Nurse | 6831 Mader Dr. #210, #210, Madison, WI 53719 | 2017-10-17 |
| Find all providers in zip 53719 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| 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 interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306446257 | Richard Harry Goldberg | Social Worker | 1514 Wood Ln, Madison, WI 53705-1457 | 2020-10-29 |
| 1710586219 | Megan Beckler | Social Worker | 49 Kessel Ct Bldg 25, Madison, WI 53711-6200 | 2020-10-26 |
| 1003436759 | Creating Space, LLC | Social Worker | 1915 Winnebago St Ste 101, Madison, WI 53704-5322 | 2020-04-23 |
| 1871143370 | Cecilia Goldschmidt | Social Worker | 2445 Darwin Rd Ste 15, Madison, WI 53704-3116 | 2019-09-17 |
| 1699321760 | Golden Vibes Counseling Center | Social Worker | 303 S Paterson St, Madison, WI 53703-4528 | 2019-08-14 |
| 1285293530 | Bianca Whitney | Social Worker | 506 Charles Ln, Madison, WI 53711-1312 | 2019-06-11 |
| 1598322505 | Judith Coursen Stevens | Social Worker | 147 Durham Road, Madison, CT 06443-1262 | 2019-05-24 |
| 1750840575 | Kimberly Michelle Horton | Social Worker | 102 Crabapple Grv, Madison, MS 39110-7098 | 2019-03-19 |
| 1497211387 | Latasha Monique Williams | Social Worker | Patriot Place (va), 314 Williams Avenue, Ste. 100, Madison, TN 37115 | 2019-02-15 |
| 1528536976 | Emily Elizabeth Morris | Social Worker | 4002 Nakoosa Trl, Madison, WI 53714-1314 | 2018-11-04 |
| Find all providers in MADISON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.