Provider Demographics
NPI:1265586614
Name:BIRKE, RITA GAY (ACADC)
Entity type:Individual
Prefix:MRS
First Name:RITA
Middle Name:GAY
Last Name:BIRKE
Suffix:
Gender:F
Credentials:ACADC
Other - Prefix:
Other - First Name:RITA
Other - Middle Name:GAY
Other - Last Name:KOENIGSFELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CAC
Mailing Address - Street 1:2511 JONES ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51104-3525
Mailing Address - Country:US
Mailing Address - Phone:402-721-1414
Mailing Address - Fax:402-753-9914
Practice Address - Street 1:212 EAST 8TH ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:60825
Practice Address - Country:US
Practice Address - Phone:402-721-1414
Practice Address - Fax:402-753-9914
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA86062101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)