Healthcare Provider Details

I. General information

NPI: 1811275753
Provider Name (Legal Business Name): RITA LYNN HANSEN CCDCIII, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2011
Last Update Date: 05/03/2026
Certification Date: 05/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3508 S MINNESOTA AVE # 100
SIOUX FALLS SD
57105-6457
US

IV. Provider business mailing address

123 19TH ST NE
WATERTOWN SD
57201-2823
US

V. Phone/Fax

Practice location:
  • Phone: 605-610-9228
  • Fax: 605-496-9989
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: