MEDICARE: SARA DITTL 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
1	101YP2500X	Professional Counselor	5030-125	WI

General Provider Information

NPI Number	:	1962346668
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA DITTL LPC

Provider Business Mailing Address
First Line	:	2736 N CARLTON PL
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53210-2150
Country	:	US
Telephone Number	:	414-651-0576
Fax Number	:

Provider Business Practice Location Address
First Line	:	823 S 60TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53214-3372
Country	:	US
Telephone Number	:	414-456-1155
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/15/2026
Last Update Date	:	04/15/2026

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Directions to “ SARA DITTL LPC” Practice Location

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