D.J. (Donald) Jay Diebold, LISAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LISAC-11485 Issued in AZ

Practice address

4850 E Desert Cove Ave Unit 141
Scottsdale, AZ 85254-5392

Phone

(480) 650-1020

NPI assigned

Sep 5, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1188950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188950400000",
    "number": "1063606705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4850 E DESERT COVE AVE UNIT 141",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852545392",
            "telephone_number": "480-650-1020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 E DESERT COVE AVE UNIT 141",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852545392",
            "telephone_number": "480-650-1020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEBOLD",
        "first_name": "D.J. (DONALD)",
        "middle_name": "JAY",
        "credential": "LISAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-05",
        "last_updated": "2007-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "AZ",
            "license": "LISAC-11485",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "LISAC-11485",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LISAC-11485",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Drew Taylor Dickinson, PHARMD, MPH
• Natasha Nicole Dickinson
• Rolland Collier Dickson, M.D.
• Robert L Dicus, DDS
• Laura Didea, DNP
• Caleb Diercks
• Bob Dennis Dietrich, D.O
• Shenen Leavitt Dietrich, DO
• Alberto Diez Montiel, MD
• Digestive Health Specialists Arizona PC

• Addiction (Substance Use Disorder) Counselor in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Addiction (Substance Use Disorder) Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.