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Individual

CANDICE NICOLE DIENBERG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW, SAC

Contact information

Practice address
6510 GRAND TETON PLZ STE 402, MADISON, WI 53719-1029
(855) 458-4966
(608) 841-1200
Mailing address
6510 GRAND TETON PLZ STE 402, MADISON, WI 53719-1029
(855) 458-4966
(608) 841-1200

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
15826-131
WI
1041C0700X
Clinical Social Worker
Primary
9228-123
WI

Other

Enumeration date
03/04/2014
Last updated
10/30/2020
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