Healthcare Provider Details

I. General information

NPI: 1669054441
Provider Name (Legal Business Name): CHILDWORKS THERAPY CLINIC, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2021
Last Update Date: 12/23/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 S LAKEPORT ST STE 102
SIOUX CITY IA
51106-9533
US

IV. Provider business mailing address

4300 S LAKEPORT ST STE 102
SIOUX CITY IA
51106-9533
US

V. Phone/Fax

Practice location:
  • Phone: 605-290-2939
  • Fax: 605-305-3204
Mailing address:
  • Phone: 605-290-2939
  • Fax: 605-305-3204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ABBIE ANN GACKE
Title or Position: OWNER, SPEECH LANGUAGE PATHOLOGIST
Credential: M.A. CCC-SLP
Phone: 605-290-2939