Healthcare Provider Details

I. General information

NPI: 1558439182
Provider Name (Legal Business Name): MATTHEW ALLEN DITTMER LSCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 SW 3RD ST UNIT 1A
TOPEKA KS
66606-2438
US

IV. Provider business mailing address

1170 SW MISSION AVE STE B
TOPEKA KS
66604-1894
US

V. Phone/Fax

Practice location:
  • Phone: 785-270-4630
  • Fax:
Mailing address:
  • Phone: 785-506-3600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLMSW 5746
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number4018
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: