Active NPI
Kyleigh Dietterick
- Addiction (Substance Use Disorder) Counselor
- Watsontown, PA
National Provider Identifier
1376327213
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- Practice address
- 759 Susquehanna TRL
Watsontown, PA 17777-8109 - Phone
- (570) 428-9504
- NPI assigned
- Aug 22, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Primary |
Addresses
Primary practice location
759 Susquehanna TRL
Watsontown, PA 17777-8109
Mailing address
110 Bue Jay Rd
Millville, PA 17846
Phone (570) 380-0941
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692662400000",
"number": "1376327213",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 BUE JAY RD",
"city": "MILLVILLE",
"state": "PA",
"postal_code": "17846",
"telephone_number": "570-380-0941"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "759 SUSQUEHANNA TRL",
"city": "WATSONTOWN",
"state": "PA",
"postal_code": "177778109",
"telephone_number": "570-428-9504"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIETTERICK",
"first_name": "KYLEIGH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-22",
"last_updated": "2023-08-22",
"certification_date": "2023-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Watsontown, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.