Lacey Deitelhoff

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

1375 E Main St
Reedsburg, WI 53959-1498

Phone

(608) 415-4449

Fax

(608) 415-4469

NPI assigned

Sep 16, 2024

Last updated

Apr 21, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Lacey Russell Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1726444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1114754009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1375 E MAIN ST",
            "city": "REEDSBURG",
            "state": "WI",
            "postal_code": "539591498",
            "telephone_number": "608-415-4449",
            "fax_number": "608-415-4469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1375 E MAIN ST",
            "city": "REEDSBURG",
            "state": "WI",
            "postal_code": "539591498",
            "telephone_number": "608-415-4449",
            "fax_number": "608-415-4469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEITELHOFF",
        "first_name": "LACEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-16",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100082081",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LACEY",
            "last_name": "RUSSELL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dean Health Systems, Inc. (SSM Health Davis Duehr Dean Eye Care - Reedsburg)
• Dean Health Systems, Inc. (Reedsburg Area Medical Specialty Center)
• Maggie Elizabeth Dederich, COTA, LMT
• Lisa Marie Dehn, DPT
• Kaylynn Deitelhoff
• Kellie Elaine Deitrich, MS
• Nicole Lee Dempsey, CEP
• Elizabeth Dingwall, PA-C
• Jessica L Dominguez
• Karlee Dulak, PHARMD

• Behavior Analyst in Reedsburg, WI
• Providers in Reedsburg, WI by specialty
• Behavior Analyst in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.