Provider Demographics
NPI:1255929824
Name:LEAH DITTMAN, LMHC LLC
Entity type:Organization
Organization Name:LEAH DITTMAN, LMHC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:
Authorized Official - Last Name:DITTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:774-231-8757
Mailing Address - Street 1:675 VFW PKWY STE 168
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-3656
Mailing Address - Country:US
Mailing Address - Phone:774-231-8757
Mailing Address - Fax:
Practice Address - Street 1:185 DEVONSHIRE ST STE 501
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02110-1415
Practice Address - Country:US
Practice Address - Phone:774-231-8757
Practice Address - Fax:857-350-3076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-08
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health