| Kellie Elaine Deitrich, MS | |
|
2155 E Main St, Reedsburg, WI 53959-9440 | |
| (608) 415-9956 | |
| Not Available |
| Full Name | Kellie Elaine Deitrich |
|---|---|
| Gender | Female |
| Speciality | Counselor |
| Location | 2155 E Main St, Reedsburg, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376295683 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | 5124-226 (Wisconsin) | Primary |
| Entity Name | Sauk County |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1528056819 PECOS PAC ID: 7618931148 Enrollment ID: O20041115001185 |
| Mailing Address | Practice Location Address |
|---|---|
| Kellie Elaine Deitrich, MS 800 Mary Ave, Reedsburg, WI 53959-1119 Ph: (608) 415-7187 | Kellie Elaine Deitrich, MS 2155 E Main St, Reedsburg, WI 53959-9440 Ph: (608) 415-9956 |
Heather Jo Klang, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2155 E Main St, Reedsburg, WI 53959 Phone: 608-415-9956 | |
Lauren E. Young, MA, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2155 E Main St, Reedsburg, WI 53959 Phone: 608-415-3296 | |
Victoria Lynn Braun, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1470 Inverness Ct, Reedsburg, WI 53959 Phone: 608-495-6117 | |
Jamie B Rogers, MS Counselor Medicare: Not Enrolled in Medicare Practice Location: 222 N Walnut St, Reedsburg, WI 53959 Phone: 608-562-3976 | |
Dakota R Goodman, SAC-IT Counselor Medicare: Not Enrolled in Medicare Practice Location: 2213 E Main St, Reedsburg, WI 53959 Phone: 608-768-4545 | |
Dr. Steven Garritt Benish, PH.D. Counselor Medicare: Accepting Medicare Assignments Practice Location: 1900 N Dewey Ave, Reedsburg, WI 53959 Phone: 608-524-6477 Fax: 608-524-8305 | |
Kaz Conrad, MA, LPC-IT Counselor Medicare: Not Enrolled in Medicare Practice Location: 348 E Main St, Reedsburg, WI 53959 Phone: 608-495-9500 |