Wilburn H Lackey, ED.D. L.P.C. L.S.O.T

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

12383 Issued in TX

Practice address

3109 Olton Rd
105E
Plainview, TX 79072-6763

Phone

(806) 293-8402

NPI assigned

Jan 4, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1437206422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 997",
            "city": "PLAINVIEW",
            "state": "TX",
            "postal_code": "790730997",
            "telephone_number": "806-774-3935",
            "fax_number": "806-293-1267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3109 OLTON RD",
            "address_2": "105E",
            "city": "PLAINVIEW",
            "state": "TX",
            "postal_code": "790726763",
            "telephone_number": "806-293-8402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACKEY",
        "first_name": "WILBURN",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "ED.D. L.P.C. L.S.O.T",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "12383",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L.P.C. LICENSE",
            "identifier": "12383",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LSOTP LICENSE",
            "identifier": "95294",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rhealine Edwinna Kilburn, COTA
• Christine Kim, DDS
• Kindstar, Inc.
• Sharla Beth Knippa, LPC
• Douglas Kopp
• Debra Lafont
• Sergio Andres Lara, MD
• Debra Lavender-Bratcher, LCSW
• Herlinda Lee, RDH
• Linda Lee, LPHA

• Professional Counselor in Plainview, TX
• Providers in Plainview, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.