KELLIE ELAINE DEITRICH MS
NPI 1376295683
Counselor in Reedsburg, WI

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: July 19, 2026.

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
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

Accepted 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.

Social Worker (Clinical)
2155 E MAIN ST
REEDSBURG, WI 53959
Counselor (Professional)
2155 E MAIN ST
REEDSBURG, WI 53959
Social Worker
2155 E MAIN ST
REEDSBURG, WI 53959
Counselor (Professional)
2155 E MAIN ST
REEDSBURG, WI 53959
Counselor (Mental Health)
2155 E MAIN ST
REEDSBURG, WI 53959
Counselor (Mental Health)
2155 E MAIN ST
REEDSBURG, WI 53959

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1376295683, enumerated as an "individual" on January 19, 2022.

The provider is located at 2155 E MAIN ST REEDSBURG, WI 53959 and the phone number is (608) 415-9956.

Counselor with taxonomy code 101Y00000X.

The provider might be accepting Accepts: Group Health Cooperative-SCW and Quartz. Please consult your insurance carrier or call the provider to verify.