John William Ditter IV, L.P.C.

Individual provider Active NPI Professional Counselor · Havertown, PA

NPI 1154873495 · NPPES record last updated Nov 3, 2016

Key facts

NPI
1154873495
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
PC009181 (PA)
Practice address
2000 Old West Chester Pike
Havertown, PA 19083-2712
Phone
(484) 454-8700
NPI assigned
Nov 3, 2016
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PC009181PAMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PC009181 PA Yes

Addresses

Primary practice location

2000 Old West Chester Pike
Havertown, PA 19083-2712

Mailing address

2000 Old West Chester Pike
Havertown, PA 19083-2712
Phone (484) 454-8700

Other providers in Havertown, PA

All providers in Havertown, PA · Professional Counselor in Pennsylvania

Sources for this page

Verify at the official NPI Registry.