Diane Marie Hietpas, MA, SAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

16529-131 Issued in WI

Practice address

W3275 Wolf River Dr
Keshena, WI 54135-9202

Phone

(715) 799-5400

Fax

(715) 799-1326

NPI assigned

Sep 21, 2022

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1663718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1386367795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 970",
            "city": "KESHENA",
            "state": "WI",
            "postal_code": "541350970",
            "telephone_number": "715-799-5400",
            "fax_number": "715-799-1326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W3275 WOLF RIVER DR",
            "city": "KESHENA",
            "state": "WI",
            "postal_code": "541359202",
            "telephone_number": "715-799-5400",
            "fax_number": "715-799-1326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIETPAS",
        "first_name": "DIANE",
        "middle_name": "MARIE",
        "credential": "MA, SAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-21",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "16529-131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark P Fuller, LCSW, SAC, ICS,
• Beth L Gillis, MD
• Joseph E Guenther, M.D.
• Holly Ann Gumieny
• Sarah Harkey, APNP
• James Garrett Hines, D.M.D
• Rachel K Hoffman, PMHNP
• Stephanie Diane Hurda, APNP
• Molly A Jacobson, MS/CCC/SLP
• Pamela E Johnson, RN

• Addiction (Substance Use Disorder) Counselor in Keshena, WI
• Providers in Keshena, WI by specialty
• Addiction (Substance Use Disorder) Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2022; 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.