Mark Daniel Dittloff, MS, LPC | |
820 Arbutus Ave, Oconto, WI 54153-2004 | |
(920) 834-8833 | |
(920) 834-8830 |
Full Name | Mark Daniel Dittloff |
---|---|
Gender | Male |
Speciality | Counselor - Professional |
Location | 820 Arbutus Ave, Oconto, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1194965590 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 64969 (Texas) | Secondary |
101YP2500X | Counselor - Professional | 8608-125 (Wisconsin) | Primary |
Entity Name | Bellin Psychiatric Center Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1952554800 PECOS PAC ID: 4486551058 Enrollment ID: O20031212000884 |
Entity Name | Oconto Hospital & Medical Center Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1356373302 PECOS PAC ID: 2163461781 Enrollment ID: O20050713000836 |
Mailing Address | Practice Location Address |
---|---|
Mark Daniel Dittloff, MS, LPC Po Box 1866, Green Bay, WI 54305-1866 Ph: (920) 445-7210 | Mark Daniel Dittloff, MS, LPC 820 Arbutus Ave, Oconto, WI 54153-2004 Ph: (920) 834-8833 |
David Schreiter, CSAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 501 Park Ave, Oconto, WI 54153 Phone: 920-834-7030 Fax: 920-834-6889 | |
Mrs. Julie A Whitworth, MS Counselor Medicare: Not Enrolled in Medicare Practice Location: 501 Park Ave, Oconto, WI 54153 Phone: 920-834-7000 Fax: 920-834-6889 | |
Todd Robert Holman, MSW LCSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 820 Arbutus Ave, Oconto, WI 54153 Phone: 920-835-5500 Fax: 920-835-5510 | |
Lori Jo Eklund Walsh, LCSW,LPC,SAC Counselor Medicare: Accepting Medicare Assignments Practice Location: 820 Arbutus Ave, Oconto, WI 54153 Phone: 920-835-5500 Fax: 920-835-5510 | |
Mr. Christopher Hanke, LPC, SAC Counselor Medicare: Medicare Enrolled Practice Location: 501 Park Ave, Oconto, WI 54153 Phone: 920-834-7019 Fax: 920-834-6889 | |
Kimberly Guerrero, LCSW CSAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 614 2nd St, Oconto, WI 54153 Phone: 920-461-6995 |