Provider Demographics
NPI:1417223363
Name:MENART, RITA MARIE (LMHC)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:MARIE
Last Name:MENART
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2360 CARTER RD
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-2933
Mailing Address - Country:US
Mailing Address - Phone:563-542-9962
Mailing Address - Fax:
Practice Address - Street 1:2101 KIMBALL AVE.
Practice Address - Street 2:SUITE 138
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50702
Practice Address - Country:US
Practice Address - Phone:319-272-2080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-26
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001055101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health