IndividualActive
Benjamin Dieffenbach, MSW, LICSW
NPI 1467809624 · Clinical Social Worker · White Bear Lake, MN
Provider details
- NPI number
- 1467809624
- Entity type
- Individual
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Credential
- MSW, LICSW
- Sex
- Male
- Sole proprietor
- No
- License
- 22483 (MN)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
2368 Joy Ave
White Bear Lake, MN 55110-7409
Phone: (651) 338-9435
Approximate (ZIP-level) locationGet directions
Mailing address
2368 Joy Ave
White Bear Lake, MN 55110-7409
Registry dates
- Enumerated
- 2016-05-18
- Last updated
- 2024-03-04
- Certified
- 2024-03-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.