Provider Demographics
NPI:1104020718
Name:HAM, RITA KAY (LMHP)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:KAY
Last Name:HAM
Suffix:
Gender:F
Credentials:LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 W F ST
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-6170
Mailing Address - Country:US
Mailing Address - Phone:402-984-3334
Mailing Address - Fax:
Practice Address - Street 1:835 S BURLINGTON AVE
Practice Address - Street 2:SUITE 108
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-6912
Practice Address - Country:US
Practice Address - Phone:402-463-7711
Practice Address - Fax:402-461-5099
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE376101YA0400X
NE1671101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE376OtherALCOHOL & DRUG COUNSELOR
NE1011OtherPROFESSIONAL COUNSELOR
NE1671OtherMENTAL HEALTH PRACTITIONE