Mr Kenneth Dittmar, M S is a
Marriage & Family Therapist based in Fayetteville, North Carolina. Mr Kenneth Dittmar is licensed to practice in North Carolina (license number 459) and his current practice location is
711 Executive Pl, Fayetteville, North Carolina. He can be reached at his office (for appointments etc.) via phone at
(910) 222-6357.
NPI number for Mr Kenneth Dittmar is 1457447765 and his current mailing address is 109 Bradford Ave, Fayetteville, North Carolina. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1457447765.
Healthcare Provider's Profile
| Full Name | Mr Kenneth Dittmar |
|---|
| Gender | Male |
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| Speciality | Marriage & Family Therapist |
|---|
| Location | 711 Executive Pl, Fayetteville, North Carolina |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1457447765
- Provider Enumeration Date: 10/05/2006
- Last Update Date: 03/29/2010
Medical Identifiers
Medical identifiers for Mr Kenneth Dittmar such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1457447765 | NPI | - | NPPES |
| 6107330 | Medicaid | NC | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103TC0700X | Psychologist - Clinical | 503 (North Carolina) | Secondary |
| 106H00000X | Marriage & Family Therapist | 459 (North Carolina) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Kenneth Dittmar is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Kenneth Dittmar, M S
109 Bradford Ave,
Fayetteville, NC 28301-5401
Ph: (910) 323-2311 | Mr Kenneth Dittmar, M S
711 Executive Pl,
Fayetteville, NC 28305-5193
Ph: (910) 222-6357 |
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