Justin Crawford Diehl, LADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

302571 Issued in MN

Practice address

976 Juno Avenue
Saint Paul, MN 55102

Phone

(651) 336-9256

NPI assigned

Sep 5, 2019

Last updated

Sep 5, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

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": "1567641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567641600000",
    "number": "1194374850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1043 GRAND AVENUE #133",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "55105",
            "telephone_number": "651-336-9256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "976 JUNO AVENUE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "55102",
            "telephone_number": "651-336-9256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEHL",
        "first_name": "JUSTIN",
        "middle_name": "CRAWFORD",
        "name_prefix": "Mr.",
        "credential": "LADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-05",
        "last_updated": "2019-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "302571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oana Dickinson, MD
• Paul B Dickinson, MD
• Jonathan Ross Dickman, M.D., PHD
• Carrie S Dickson, CNM
• Evelyn Dickson, MD
• Joseph Diehn
• Benita S Dieperink, MD
• Connie I Diercks, CNM
• Anna Dierking, DDS
• Dianna Lynn Diers, MA LAMFT

• Addiction (Substance Use Disorder) Counselor in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Addiction (Substance Use Disorder) Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2019; 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.