MR. KENNETH DITTMAR (NPI# 1457447765) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457447765 |
| Entity Type | Individual |
| Full Name | MR. KENNETH DITTMAR |
| Credential | M. S. |
| Practice Address |
711 Executive Pl Fayetteville NC 28305-5193 |
| Mailing Address |
109 Bradford Ave Fayetteville NC 28301-5401 |
| Practice Telephone | 9102226357 |
| Practice Fax Number | 9106789963 |
| Mailing Telephone | 9103232311 |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2010-03-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TC0700X |
Psychologist Specialization: Clinical |
503 | NC | Behavioral Health & Social Service Providers |
| Y | 106H00000X | Marriage & Family Therapist | 459 | NC | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 6107330 | 05 |
| Street Address |
711 EXECUTIVE PL |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28305-5193 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649707936 | Samantha Curley Britt | Psychologist | 711 Executive Pl, Fayetteville, NC 28305-5193 | 2017-05-17 |
| 1295117117 | Jasmine Akalaonu | Counselor | 711 Executive Pl, Fayetteville, NC 28305-5193 | 2015-06-27 |
| 1245618081 | Anupama Sundar | Psychiatry & Neurology | 711 Executive Pl, Fayetteville, NC 28305-5193 | 2015-05-13 |
| 1588092506 | Mallorie Lamia | Physician Assistant | 711 Executive Pl, 3rd Floor, Fayetteville, NC 28305-5193 | 2013-10-30 |
| 1114353257 | Courtney Thomas | Counselor | 711 Executive Pl, Fayetteville, NC 28305-5193 | 2013-09-20 |
| 1427382308 | Antoinette H Howard | Social Worker | 711 Executive Pl, Fayetteville, NC 28305-5193 | 2009-09-25 |
| 1649420688 | Sherry Hoang Smith | Psychologist | 711 Executive Pl, Fayetteville, NC 28305-5193 | 2008-09-26 |
| 1376793711 | Megan H Bickel | Counselor | 711 Executive Pl, Fayetteville, NC 28305-5193 | 2008-09-23 |
| 1700917390 | County of Cumberland | Durable Medical Equipment & Medical Supplies | 711 Executive Pl, Cap Program, Fayetteville, NC 28305-5193 | 2007-03-08 |
| 1659401453 | County of Cumberland | Psychiatry & Neurology | 711 Executive Pl, Fayetteville, NC 28305-5193 | 2007-03-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437637733 | Shannon S Wiggins | Social Worker | 2525 Raeford Rd Ste A, Fayetteville, NC 28305 | 2018-07-30 |
| 1205345790 | Sarah Elizabeth Hudson | Marriage & Family Therapist | 214 Fairway Dr, Fayetteville, NC 28305 | 2017-09-27 |
| 1336533116 | Avalon Counseling Services Pa | Counselor | 916 B Arsenal Ave, Fayetteville, NC 28305 | 2015-03-19 |
| 1568882827 | Kenneth Brown | Counselor | 901 Arsenal Avenue, Suite, Fayetteville, NC 28305 | 2014-04-24 |
| 1174879423 | Lynette Maxwell Pierce | Dentist | 2537-b Raeford Rd, Fayetteville, NC 28305 | 2012-07-24 |
| 1356640973 | Charlene Jones | Social Worker | 560 Lambert St, Fayetteville, NC 28305 | 2011-03-22 |
| 1659518173 | Christine R Campbell | Speech-Language Pathologist | 2401 Roberson Street, Fayettville, NC 28305 | 2009-01-21 |
| 1588814628 | Zakiya S Karim | Pediatrics | 1327 Robeson Street, Fayetteville, NC 28305 | 2008-09-25 |
| 1710134770 | Bright Heart Healthcare Staffing | Nursing Care | 2504 Rareford Rd, Fayetteville, NC 28305 | 2008-08-21 |
| 1730272402 | Dale A Childers | Dentist | 2409 Robeson Street, Fayetteville, NC 28305 | 2006-10-02 |
| Find all providers in zip 28305 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720639180 | Eugene Mack | Marriage & Family Therapist | 3608 Talus Rd, Fayetteville, NC 28306-9717 | 2019-09-26 |
| 1447755822 | Emily Jones | Marriage & Family Therapist | 5719 Danville Dr, Fayetteville, NC 28311-3419 | 2018-03-27 |
| 1871004663 | The Salt Project | Marriage & Family Therapist | 1611-b Owen Dr., Fayetteville, NC 28304 | 2017-10-19 |
| 1205345790 | Sarah Elizabeth Hudson | Marriage & Family Therapist | 214 Fairway Dr, Fayetteville, NC 28305 | 2017-09-27 |
| 1508381724 | Tina Marie Duggins | Marriage & Family Therapist | 1611b Owen Dr # 4835884, Fayetteville, NC 28304-3425 | 2017-08-09 |
| 1932640828 | Monique Rendles | Marriage & Family Therapist | 2106 Hope Mills Rd, Fayetteville, NC 28304-4226 | 2017-03-13 |
| 1629529060 | Lorna Boyer Chase | Marriage & Family Therapist | 109 White Heron Circle, Fayetteville, NY 13066 | 2016-10-20 |
| 1972958601 | Mark Knox | Marriage & Family Therapist | 1611 Owen Dr, Fayetteville, NC 28304-3425 | 2016-05-02 |
| 1861867053 | Zulima Webster | Marriage & Family Therapist | 11941 Fairway Overlook, Fayetteville, GA 30215-6637 | 2015-12-14 |
| 1124490362 | Brynn Rogers | Marriage & Family Therapist | 309 N Manlius St, Fayetteville, NY 13066-1433 | 2015-10-27 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 28305 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.