Lija Vija Ditmar, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801033390 Issued in MI

Practice address

12719 S West Bay Shore Dr Ste 7
Traverse City, MI 49684-5489

Phone

(231) 946-1610

Fax

(231) 922-5046

NPI assigned

Jan 16, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1558412403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12719 S WEST BAY SHORE DR STE 7",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496845489",
            "telephone_number": "231-946-1610",
            "fax_number": "231-922-5046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12719 S WEST BAY SHORE DR STE 7",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496845489",
            "telephone_number": "231-946-1610",
            "fax_number": "231-922-5046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DITMAR",
        "first_name": "LIJA",
        "middle_name": "VIJA",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801033390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick H Dillon, MD
• Philip Michael Dimondo, PHARMD
• Travis Todd Disbrow, RPH
• Wendi Irene Disbrow, PT
• Discover Health Chiropractic Center PC
• Cynthia Diver, PT
• Angela Kay Dixon, LMSW
• Rebecca R. Dobler, LMSW
• Stacy Zachman Dobreff, PA-C
• Shannon Dodds, LMSW

• Clinical Social Worker in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.