| Mrs Suzette Carolyn-eve Diederich, MS ED, LPC | |
|
123 N Oakland Ave, Green Bay, WI 54303-2831 | |
| (920) 770-4088 | |
| (651) 705-0026 |
| Full Name | Mrs Suzette Carolyn-eve Diederich |
|---|---|
| Gender | Female |
| Speciality | Counselor - Professional |
| Location | 123 N Oakland Ave, Green Bay, Wisconsin |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609972280 | NPI | - | NPPES |
| 40967700 | Medicaid | WI | |
| 60291900 ID=7 | Other | WI | EDI TRADING PARTNER NO. |
| 3387-125 | Other | WI | LICENSED PROFESSIONAL COU |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 3387-125 (Wisconsin) | Secondary |
| 101YP2500X | Counselor - Professional | 3387-125 (Wisconsin) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Suzette Carolyn-eve Diederich, MS ED, LPC 3645 Wildcat Trl Apt 3, New Franken, WI 54229-9207 Ph: (920) 366-8590 | Mrs Suzette Carolyn-eve Diederich, MS ED, LPC 123 N Oakland Ave, Green Bay, WI 54303-2831 Ph: (920) 770-4088 |
Louise Clara Daul, MS, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 123 N Oakland Ave, Green Bay, WI 54303 Phone: 920-770-4088 Fax: 651-705-0026 | |
Kristin Flannery, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2920 S Webster Ave, Green Bay, WI 54301 Phone: 920-639-1914 | |
Mr. John Barajas, LPC-IT, SAC-IT Counselor Medicare: Medicare Enrolled Practice Location: 424 S Monroe Ave Ste 201, Green Bay, WI 54301 Phone: 920-445-0170 Fax: 920-445-0174 | |
Robyn L Rickert, M.S., L.P.C. Counselor Medicare: Not Enrolled in Medicare Practice Location: 130 E Walnut St, Suite 406, Green Bay, WI 54301 Phone: 920-884-1187 Fax: 920-227-4100 | |
Joanne Marie Torres, LPC, CSAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2640 West Point Road, Green Bay, WI 54304 Phone: 920-490-3790 | |
Mr. Christopher Anthony Buckman, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 1499 6th St, Green Bay, WI 54304 Phone: 920-497-6161 Fax: 920-498-0476 | |
Jodi Anderson, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2325 Verlin Rd Ste 203, Green Bay, WI 54311 Phone: 920-655-0859 |