Provider Demographics
NPI:1003321290
Name:RINKE, KAITLYN (LCPC)
Entity Type:Individual
Prefix:
First Name:KAITLYN
Middle Name:
Last Name:RINKE
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8112 FLAGSTONE ST
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60431-8483
Mailing Address - Country:US
Mailing Address - Phone:815-274-0366
Mailing Address - Fax:
Practice Address - Street 1:727 E ETNA RD
Practice Address - Street 2:
Practice Address - City:OTTAWA
Practice Address - State:IL
Practice Address - Zip Code:61350-1040
Practice Address - Country:US
Practice Address - Phone:815-434-4727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-10
Last Update Date:2017-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.011125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional