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MRS. SUZETTE CAROLYN-EVE DIEDERICH M.S. ED., L.P.C.
NPI 1609972280
Counselor - Professional in Green Bay, WI

Active since September 15, 2006PECOS Enrolled
123 N OAKLAND AVE, GREEN BAY, WI 54303(920) 770-4088(651) 705-0026 Get Directions Write a Review

NPPES record last updated: June 9, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 9, 2022, Sep 14, 2021 (2 updates tracked since 2021).

About Mrs. Suzette Carolyn-eve Diederich M.s. Ed., L.p.c. NPPES

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

MRS. SUZETTE CAROLYN-EVE DIEDERICH M.S. ED., L.P.C. (NPI 1609972280) is an individual professional provider in Green Bay, Wisconsin, licensed in Wisconsin (3387-125) and active in the NPI registry since September 2006. She is enrolled in Medicare PECOS and is a graduate of Other (2000).

NPPES Registry Identity

NPI1609972280
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameMRS. SUZETTE CAROLYN-EVE DIEDERICHCredential: M.S. ED., L.P.C.
Location Address123 N OAKLAND AVEGreen Bay, WI 54303-2831
Mailing Address3645 Wildcat Trl Apt 3New Franken, WI 54229-9207 · (920) 366-8590
Phone(920) 770-4088
Fax(651) 705-0026
Sole ProprietorYes
Medical School CMSOtherGraduated 2000
Enumeration DateSeptember 15, 2006
Last NPPES UpdateJune 9, 20222 updates tracked since enumeration
NPPES CertifiedJune 9, 2022
✔ NPI 1609972280 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in WI · 3387-125
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License 3387-125 (WI)
123 N OAKLAND AVE, Green Bay, WI 54303
Open in Google Maps ↗

Other Identifiers 3

Other3387-125WI · Licensed Professional Cou
Other60291900 ID=7WI · Edi Trading Partner No.
Medicaid40967700WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners, Network Health, Quartz and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Suzette Carolyn-eve Diederich M.s. Ed., L.p.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2860969227
PECOS Enrollment IDI20260423001279
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.

Medicare Billing Reassignment

Medicare enrollment records show Suzette Diederich reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Power For Change, LLC
Same address
Mental Health (Including Community Mental Health Center)
123 N OAKLAND AVE
Green Bay, WI 54303
  • Reassigned Medicare billing, Wisconsin enrollment
  • 4 clinicians in this Medicare group
NPI 1124322284 (920) 770-4088

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

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

LOUISE CLARA DAUL MS, LPC
Counselor (Professional)
123 N OAKLAND AVE
GREEN BAY, WI 54303
Brown County (920) 770-4088
KABLIA YANG
Counselor (Mental Health)
123 N OAKLAND AVE
GREEN BAY, WI 54303
Brown County (920) 770-4088
POWER FOR CHANGE, LLC
Clinic/Center (Mental Health (Including Community Mental Health Center))
123 N OAKLAND AVE
GREEN BAY, WI 54303
Brown County (920) 770-4088
LEXANA RUTZ LPC-IT
Counselor (Professional)
123 N OAKLAND AVE
GREEN BAY, WI 54303
Brown County (920) 770-4088
SHANNON LEE WYMAN KENEVAN
Counselor (Professional)
123 N OAKLAND AVE
GREEN BAY, WI 54303
Brown County (920) 770-4088
RACHELE WATKINS APSW
Social Worker
123 N OAKLAND AVE
GREEN BAY, WI 54303
Brown County (920) 770-4088
ALISHA PETROUSKE
Counselor (Professional)
123 N OAKLAND AVE
GREEN BAY, WI 54303
Brown County (920) 770-4088
MR. STEVE A SHEFCHIK MA, LPC
Counselor (Professional)
123 N OAKLAND AVE
GREEN BAY, WI 54303
Brown County (920) 770-4088

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Suzette Diederich's NPI number?

The NPI number for Suzette Diederich is 1609972280. It was assigned to this individual provider in the NPPES registry on September 15, 2006.

Where is Suzette Diederich located?

Suzette Diederich practices at 123 N Oakland Ave, Green Bay, WI 54303. The listed phone number is (920) 770-4088.

What is Suzette Diederich's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Suzette Diederich enrolled in Medicare?

Yes. Suzette Diederich is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Suzette Diederich's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Suzette Diederich reassigns Medicare benefits to Power For Change, LLC (Green Bay, WI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Suzette Diederich's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Suzette Diederich accept?

Health plans from HealthPartners, Network Health, Quartz, Security Health Plan and UnitedHealthcare list Suzette Diederich as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Suzette Diederich was last updated on June 9, 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.