Michelle Marie Diffenbaugh, LADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

302501 Issued in MN

Practice address

1885 University Ave
Suite 246
St. Paul, MN 55104-3489

Phone

(612) 326-7563

Fax

(651) 647-9147

NPI assigned

Apr 13, 2011

Last updated

Apr 13, 2011By the provider in NPPES

Sex

Female

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": "1302652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302652800000",
    "number": "1922398809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1885 UNIVERSITY AVE",
            "address_2": "SUITE 246",
            "city": "ST. PAUL",
            "state": "MN",
            "postal_code": "55104",
            "telephone_number": "612-326-7563",
            "fax_number": "651-647-9147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1885 UNIVERSITY AVE",
            "address_2": "SUITE 246",
            "city": "ST. PAUL",
            "state": "MN",
            "postal_code": "551043489",
            "telephone_number": "612-326-7563",
            "fax_number": "651-647-9147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIFFENBAUGH",
        "first_name": "MICHELLE",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "LADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-13",
        "last_updated": "2011-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "302501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Connie I Diercks, CNM
• Anna Dierking, DDS
• Dianna Lynn Diers, MA LAMFT
• Elizabeth Dietz, MD
• James Bradley Dietz, D.C.
• Jack Difino
• Carol Difrancesco
• Heather Lee Digolo, MA
• Jeff Ray Digre, PHARM D
• Nevin D Dikel, MD

• 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 Apr 13, 2011; 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.