Healthcare Provider Details

I. General information

NPI: 1508269895
Provider Name (Legal Business Name): PATRICIA ANN DITTMEIER LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2014
Last Update Date: 10/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2347 VINE ST
CINCINNATI OH
45219-1745
US

IV. Provider business mailing address

2347 VINE ST
CINCINNATI OH
45219-1745
US

V. Phone/Fax

Practice location:
  • Phone: 513-621-1117
  • Fax: 513-621-2350
Mailing address:
  • Phone: 513-621-1117
  • Fax: 513-621-2350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number0800386
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0800386
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number0800386
License Number StateOH
# 4
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0800386
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: