Healthcare Provider Details

I. General information

NPI: 1053541805
Provider Name (Legal Business Name): DITTMAR COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2009
Last Update Date: 07/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 HARTMAN RD SUITE D
GREENSBURG PA
15601-6463
US

IV. Provider business mailing address

125 HARTMAN RD SUITE D
GREENSBURG PA
15601-6463
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 TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberCW006295L
License Number StatePA

VIII. Authorized Official

Name: MRS. ANN DITTMAR
Title or Position: CO-OWNER
Credential: LCSW
Phone: 724-610-7726