Provider Demographics
NPI:1386933646
Name:DITTMAR, JOHN N (LPC)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:N
Last Name:DITTMAR
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4963 ROUTE 30
Mailing Address - Street 2:SUITE 204
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-2343
Mailing Address - Country:US
Mailing Address - Phone:724-610-7726
Mailing Address - Fax:724-420-5739
Practice Address - Street 1:4963 ROUTE 30
Practice Address - Street 2:SUITE 204
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-2343
Practice Address - Country:US
Practice Address - Phone:724-610-7726
Practice Address - Fax:724-420-5739
Is Sole Proprietor?:No
Enumeration Date:2011-04-06
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005847101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional