Anna Ruth Ditesheim, LCSW-A

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P020748 Issued in NC

Practice address

620 W Lane St Ste 202
Raleigh, NC 27603-1441

Phone

(704) 650-4777

NPI assigned

Jul 3, 2024

Sex

Unspecified or another gender identity

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• A.R. Ditesheim Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1719964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1093551509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 SHORESIDE DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277135507",
            "telephone_number": "704-650-4777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 W LANE ST STE 202",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276031441",
            "telephone_number": "704-650-4777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DITESHEIM",
        "first_name": "ANNA",
        "middle_name": "RUTH",
        "credential": "LCSW-A",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2024-07-03",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P020748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "A.R.",
            "last_name": "DITESHEIM",
            "credential": "LCSW-A",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Meagan Nicole Dirven
• Linda Annette Disalvo, MSN, FNP-BC, WHNP-BC
• Tiffany Kelly Disanzo
• Jennifer Dismuke
• Dispatchhealth, PC
• Renee Beatrice Dito, RDH
• Gabrielle Hope Ditrani, OTR/L
• Christine Denise Dittmer, M.D., MPH, MS
• Joshua Eugene Dittmer, M.D.
• Traci Annette Diveley, PTA

• Clinical Social Worker in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.