Athena Marie Diesch-Chham, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

20955 Issued in MN

Practice address

410 Church St SE
Minneapolis, MN 55455-0222

Phone

(507) 676-1633

NPI assigned

Jun 12, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Restorative Path Counseling and Wellbeing

  • Clinical Social Worker
  • Farmington, MN
  • NPI 1215607940

  Clinical

  NPD Authorized official
• Regents of the University of Minnesota

  • Student Health Clinic/Center
  • Minneapolis, MN
  • NPI 1013137355
  NPD
• Regents of the University of Minnesota

  • Federally Qualified Health Center (FQHC)
  • Minneapolis, MN
  • NPI 1114019858
  NPD
• Regents of the University of Minnesota

  • Clinic Pharmacy
  • Minneapolis, MN
  • NPI 1528288875
  NPD

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

{
    "created_epoch": "1528761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632960000000",
    "number": "1508359704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22426 CANTREL WAY",
            "city": "FARMINGTON",
            "state": "MN",
            "postal_code": "550244011",
            "telephone_number": "507-676-1633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 CHURCH ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550222",
            "telephone_number": "507-676-1633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIESCH-CHHAM",
        "first_name": "ATHENA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-12",
        "last_updated": "2021-09-30",
        "certification_date": "2021-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "20955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Titanium",
            "affiliation": "N",
            "endpointDescription": "EMR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "410 Church St SE",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554550222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Eric W Dieperink, M.D.
• Michael E Dieperink, MD
• Mary Therese Dierich, GNP
• Darcia M Dierking, AU.D.
• Benjamin Dierks
• Natalie Dieterle, PA
• Drew Thomas Dietle, M.D.
• Bobbi Jo Dietrich, CPHT
• Elena Megan Dietz-Mann, MSW, LICSW
• Charles Albert Dietz Jr., M.D.

• All providers in Minneapolis, MN
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.