KELLIE ELAINE DEITRICH MS
NPI 1376295683
Counselor in Reedsburg, WI

Q: What is Kellie Deitrich's NPI number?

The NPI number for Kellie Deitrich is 1376295683. It was assigned to this individual provider in the NPPES registry on January 19, 2022.

Q: What is Kellie Deitrich's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

Q: When was this NPI record last updated?

The NPPES record for Kellie Deitrich was last updated on January 19, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since January 19, 2022PECOS EnrolledAccepts Medicare Assignment

2155 E MAIN ST, REEDSBURG, WI 53959(608) 415-9956 Get Directions Write a Review

NPPES record last updated: January 19, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Kellie Elaine Deitrich Ms NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLIE ELAINE DEITRICH MS (NPI 1376295683) is an individual counselor in Reedsburg, Wisconsin, licensed in Wisconsin (5124-226) and active in the NPI registry since January 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1376295683

Entity TypeIndividualFemale

Primary Taxonomy101Y00000X

Provider Legal NameKELLIE ELAINE DEITRICHCredential: MS

Location Address2155 E MAIN STReedsburg, WI 53959-9440

Mailing Address800 Mary AveReedsburg, WI 53959-1119 · (608) 415-7187

Phone(608) 415-9956

Sole ProprietorYes

Medical School CMSOtherGraduated 2021

Enumeration DateJanuary 19, 2022

NPPES CertifiedJanuary 19, 2022

✔ NPI 1376295683 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers

Taxonomy Code101Y00000X

License✔ Licensed in WI · 5124-226

Definition

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

2155 E MAIN ST, Reedsburg, WI 53959

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Group Health Cooperative-SCW, Quartz.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kellie Elaine Deitrich Ms is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8628509742

PECOS Enrollment IDI20241001001269

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HEATHER JO KLANG

Counselor (Professional)