MRS. REBECCA L BIRK (NPI# 1235284464) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235284464 |
| Entity Type | Individual |
| Full Name | MRS. REBECCA L BIRK |
| Credential | MA LCPC |
| Practice Address |
1770 E Lake Shore Dr #208 Decatur IL 62521 |
| Practice Telephone | 2174281900 |
| Practice Fax Number | 2174280358 |
| Mailing Telephone | 2174281900 |
| Mailing Fax Number | 2174280358 |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
IL | Behavioral Health & Social Service Providers |
| Street Address |
1770 E LAKE SHORE DR #208 |
| City | DECATUR |
| State | IL |
| Zip Code | 62521 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942292412 | David Anthony Jones | Family Medicine | 1770 E Lake Shore Dr, Suite 305, Decatur, IL 62521-3832 | 2005-08-19 |
| 1306314778 | Kristy Dawn Shafer | Nurse Practitioner | 1770 E Lake Shore Dr, Decatur, IL 62521-3832 | 2018-11-05 |
| 1902340730 | Annie Michele Smith | Social Worker | 1770 E Lake Shore Dr, #209, Decatur, IL 62521-3832 | 2016-12-13 |
| 1013319623 | Nicole Marie Lord | Nurse Practitioner | 1770 E Lake Shore Dr, #309, Decatur, IL 62521-3832 | 2014-09-25 |
| 1508110198 | Leslie Stanislaus Anewenah | Surgery | 1770 E Lake Shore Dr, Decatur, IL 62521-3832 | 2012-11-04 |
| 1063797108 | Laurel A Walton Do Sc | Obstetrics & Gynecology | 1770 E Lake Shore Dr, Ste 309, Decatur, IL 62521-3832 | 2011-10-20 |
| 1447532924 | Ahmad H Ahmad Md Sc | Internal Medicine | 1770 E Lake Shore Dr, Ste 201, Decatur, IL 62521-3832 | 2011-09-12 |
| 1912233602 | Linda Wilson Klemm | Nurse Practitioner | 1770 E Lake Shore Dr, Suite 105, Decatur, IL 62521-3832 | 2009-10-30 |
| 1265675490 | Jennifer Ross-barnett | Nurse Practitioner | 1770 E Lake Shore Dr, Suite 207, Decatur, IL 62521-3831 | 2009-04-17 |
| 1447403936 | Choudary V. Kavuri Md, Sc | Psychiatry & Neurology | 1770 E Lake Shore Dr, Suite 208, Decatur, IL 62521-3832 | 2008-10-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053927988 | Caleb David Braasch | Pharmacist | 1818 South Airport Rd, Decatur, IL 62521 | 2020-09-16 |
| 1295390490 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | Crossing Recovery Center, 495 East Central Ave, Decatur, IL 62521 | 2019-05-03 |
| 1396300638 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | 495 E Central Ave, Decatur, IL 62521 | 2019-05-02 |
| 1679138911 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | 495 East Central Ave, Decatur, IL 62521 | 2019-05-02 |
| 1154848034 | Zack Shaw | Physical Therapist | 4855-57 East 36, Decatur, IL 62521 | 2017-08-23 |
| 1790032852 | Prashant Morolia | Family Medicine | 4775 E Maryland St, Decatur, IL 62521 | 2012-08-08 |
| 1003188913 | Evergreen Place Decatur, LLC | Assisted Living Facility | 4825 E Evergreen Court, Decatur, IL 62521 | 2012-02-08 |
| 1104133099 | Suzette Marie Shafer | Occupational Therapy Assistant | 1790 S. Fairview Ave., Decatur, IL 62521 | 2010-09-13 |
| 1467784090 | Community Health Improvement Center | Clinic/Center | 1221 East Condit Street, Decatur, IL 62521 | 2010-02-08 |
| 1982839056 | Kelly Clark Dds PC | Dentist | 3737 Us Rt 36 E, Decatur, IL 62521 | 2009-05-19 |
| Find all providers in zip 62521 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598363392 | Kimberly Swanson | Counselor | 311 West Hill Street, Decatur, GA 30030-4319 | 2020-10-14 |
| 1083228050 | Lasonja D Carter | Counselor | 2920 Frost Dr Sw, Decatur, AL 35603-4531 | 2020-09-07 |
| 1154935468 | Nick Hersey | Counselor | 1924 Clairmont Rd Ste 50, Decatur, GA 30033-3450 | 2020-09-03 |
| 1760095814 | Potters Touch Counseling Inc. | Counselor | 4150 Snapfinger Woods Dr Ste 100, Decatur, GA 30035-3417 | 2020-08-28 |
| 1407464563 | Starre Cannon | Counselor | 3183 Tarian Way, Decatur, GA 30034-5539 | 2020-07-15 |
| 1164040713 | Bethany Cecelia Merrett | Counselor | 223 Kathryn Ave, Decatur, GA 30030-5017 | 2020-07-09 |
| 1053939090 | Virtue Speaks LLC | Counselor | 4150 Snapfinger Woods Dr Ste 104d, Decatur, GA 30035-3417 | 2020-07-07 |
| 1821619842 | Knitikia Gross | Counselor | 436 Eastwyck Cir, Decatur, GA 30032-6694 | 2020-04-30 |
| 1063033074 | Marcy Renee Jefferson-watkins | Counselor | 2126 6th Ave Se Ste 208, Decatur, AL 35601-6547 | 2020-04-30 |
| 1790304004 | Tonia D Morris | Counselor | 3006 Western Sunset Ct, Decatur, GA 30034-1692 | 2020-04-16 |
| Find all providers in DECATUR | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.