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NPI Code Detail

MEDICARE: STEPHEN E DITTMER LPC

MEDICARE: STEPHEN E DITTMER LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor2012041052MO

General Provider Information

NPI Number : 1013345057
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHEN E DITTMER LPC
Provider Business Mailing Address
First Line : PO BOX 844715
Second Line :
City : KANSAS CITY
State : MO
Zip : 64184-4715
Country : US
Telephone Number : 417-761-5214
Fax Number : 417-761-5065
Provider Business Practice Location Address
First Line : 3401 BERRYWOOD DR
Second Line :
City : COLUMBIA
State : MO
Zip : 65201-8372
Country : US
Telephone Number : 573-777-8330
Fax Number : 573-777-8390
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/30/2013
Last Update Date : 05/14/2026

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