Healthcare Provider Details

I. General information

NPI: 1932501236
Provider Name (Legal Business Name): DITTMAR COUNSELING SERVICES, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2014
Last Update Date: 11/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4936 ROUTE 30 SUITE 204
GREENSBURG PA
15601-2343
US

IV. Provider business mailing address

4936 ROUTE 30 SUITE 204
GREENSBURG PA
15601-2343
US

V. Phone/Fax

Practice location:
  • Phone: 724-610-7726
  • Fax: 724-420-5739
Mailing address:
  • Phone: 724-610-7726
  • Fax: 724-420-5739

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW006295L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name: MRS. ANN S DITTMAR
Title or Position: CLINICIAN/OWNER
Credential: LCSW
Phone: 724-853-6942