KELLIE ELAINE DEITRICH (MS) – Counselor, NPI 1376295683

KELLIE ELAINE DEITRICH (MS) is a healthcare provider. based in Reedsburg, Wisconsin. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials MS. They hold a License No. 5124-226 (WI). The NPI Number for KELLIE ELAINE DEITRICH (MS) is 1376295683

Main info

Female
Sole Proprietor
5 Years Of Experience
Accepts Medicare Assignment
Name
KELLIE ELAINE DEITRICH (MS)
NPI
1376295683
Phone
(608) 415-7187
Address
800 MARY AVE
Enumeration Date
19 January 2022
Last Update Date
19 January 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6083554200
Graduation Year
2021 (5 years ago)
PAC ID
8628509742
Group Practice PAC ID
7618931148
Professional Enrollment ID
I20241001001269
Address ID
WI539132183BA505XXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:4State licenses:1Digital endpointsOther names

1,748 MENTAL HEALTH COUNSELOR in WI

Provider Addresses for KELLIE ELAINE DEITRICH (MS)

  • 800 MARY AVE

    REEDSBURG, WI 539591119

    Phone: (608) 415-7187

    Type: Mailing

  • 2155 E MAIN ST

    REEDSBURG, WI 539599440

    Phone: (608) 415-9956

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-10-01

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241001001269IMental Health CounselorWITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 53959)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7618931148View full group profile
NameSpecialtyState
Clinical Social WorkerWI
P S Y C H I A T R YWI
Nurse PractitionerWI
Mental Health CounselorMN
Nurse PractitionerWI
Clinical Social WorkerWI
Physician AssistantWI
Clinical Social WorkerWI
Mental Health CounselorWI
Nurse PractitionerWI

Reviews

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Frequently asked questions

What is the standard ID for KELLIE ELAINE DEITRICH (MS) in the U.S.?
In the U.S., KELLIE ELAINE DEITRICH (MS) is identified by NPI 1376295683.
Does the public listing show KELLIE ELAINE DEITRICH (MS) as active?
KELLIE ELAINE DEITRICH (MS)'s NPI record reflects an active status in NPPES.
What type of care does KELLIE ELAINE DEITRICH (MS) provide?
KELLIE ELAINE DEITRICH (MS)'s profile centers on Counselor. Clinical services aligned with this taxonomy classification.
Which community is linked to KELLIE ELAINE DEITRICH (MS)?
KELLIE ELAINE DEITRICH (MS) shows a connection to Reedsburg, Wisconsin in registry-derived data.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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