Candice Nicole Dienberg, LCSW, SAC is a medicare enrolled "Social Worker - Clinical" provider in Madison, Wisconsin. Her current practice location is
6510 Grand Teton Plz Ste 402, Madison, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(855) 458-4966.
Candice Nicole Dienberg is licensed to practice in Wisconsin (license number 9228-123) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1376968073.
Healthcare Provider's Profile
| Full Name | Candice Nicole Dienberg |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 6510 Grand Teton Plz Ste 402, Madison, Wisconsin |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1376968073
- Provider Enumeration Date: 03/04/2014
- Last Update Date: 10/30/2020
Medicare PECOS Information:
- PECOS PAC ID: 8426487372
- Enrollment ID: I20200330000235
Medical Identifiers
Medical identifiers for Candice Nicole Dienberg such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1376968073 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 15826-131 (Wisconsin) | Secondary |
| 1041C0700X | Social Worker - Clinical | 9228-123 (Wisconsin) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Candice Nicole Dienberg allows following entities to bill medicare on her behalf.
| Entity Name | Cornerstone Counseling Services Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1033127246
PECOS PAC ID: 1456256023
Enrollment ID: O20031205000446 |
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| Entity Name | Healthyminds, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1942780432
PECOS PAC ID: 6709297906
Enrollment ID: O20201119000373 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Candice Nicole Dienberg is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Candice Nicole Dienberg, LCSW, SAC
6510 Grand Teton Plz Ste 402,
Madison, WI 53719-1029
Ph: (855) 458-4966 | Candice Nicole Dienberg, LCSW, SAC
6510 Grand Teton Plz Ste 402,
Madison, WI 53719-1029
Ph: (855) 458-4966 |
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