Individual provider Active NPI

Lisa Marie Dittman, MA, NCC, LPC

  • Mental Health Counselor
  • Brick, NJ
National Provider Identifier
1215563184
Registry record updated Mar 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
37PC00045500 Issued in NJ
Practice address
3 Creek Rd
Brick, NJ 08724-3305
Phone
(732) 840-1516
NPI assigned
Mar 22, 2020
Last updated
Mar 22, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 37PC00045500 NJ Primary

Addresses

Primary practice location

3 Creek Rd
Brick, NJ 08724-3305

Mailing address

3 Creek Rd
Brick, NJ 08724-3305
Phone (732) 840-1516

Other identifiers 1

IdentifierTypeStateIssuer
37PC00045500OtherNJNON MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250414000774 NJ Practitioner - Mental Health Counselor 4789108598 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Perlman Counseling and Supervision Services LLCGroup PAC ID 8729501903, 5 clinicians

Practice addresses (Care Compare)

200 Atlantic Ave
Suite M
Manasquan, NJ 08736-1352
Phone (732) 292-4504

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Perlman Counseling and Supervision Services LLC CurrentSince Apr 1, 2025 Accepting new patients

Locations

200 Atlantic Ave
Ste M
Manasquan, NJ 08736
Phone (732) 292-4504

200 Atlantic Ave
Ste R
Manasquan, NJ 08736
Phone (732) 292-4504

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1584835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584835200000",
    "number": "1215563184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 CREEK RD",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087243305",
            "telephone_number": "732-840-1516",
            "fax_number": "732-840-1516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 CREEK RD",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087243305",
            "telephone_number": "732-840-1516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DITTMAN",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "MA, NCC, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-22",
        "last_updated": "2020-03-22",
        "certification_date": "2020-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "37PC00045500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NON MEDICARE",
            "identifier": "37PC00045500",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brick, NJ

Sources for this page

Verify at the official NPI Registry.