Provider Demographics
NPI:1386387140
Name:DIENSTBERGER, ARIELLE (LSW)
Entity type:Individual
Prefix:
First Name:ARIELLE
Middle Name:
Last Name:DIENSTBERGER
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3041 COUNTY ROAD 2000
Mailing Address - Street 2:
Mailing Address - City:JEROMESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44840-9758
Mailing Address - Country:US
Mailing Address - Phone:419-289-4825
Mailing Address - Fax:419-289-4826
Practice Address - Street 1:3041 COUNTY ROAD 2000
Practice Address - Street 2:
Practice Address - City:JEROMESVILLE
Practice Address - State:OH
Practice Address - Zip Code:44840-9758
Practice Address - Country:US
Practice Address - Phone:419-289-4825
Practice Address - Fax:413-289-4826
Is Sole Proprietor?:No
Enumeration Date:2022-04-19
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1450306104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1073952271Medicaid