Active NPI
Rachel Rene Wilder, LPC
- Professional Counselor
- Lubbock, TX
National Provider Identifier
1639545973
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 70258
- Practice address
- 3809 22ND St
2D
Lubbock, TX 79410-1198 - Phone
- (806) 789-5146
- NPI assigned
- Aug 20, 2015
- Last updated
- Sep 29, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 70258 | TX | Primary |
Addresses
Primary practice location
3809 22ND St
2D
Lubbock, TX 79410-1198
Mailing address
5731 68TH St
Lubbock, TX 79424-1411
Phone (806) 789-5146
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 70258 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443484800000",
"number": "1639545973",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5731 68TH ST",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794241411",
"telephone_number": "806-789-5146"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3809 22ND ST",
"address_2": "2D",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794101198",
"telephone_number": "806-789-5146"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILDER",
"first_name": "RACHEL",
"middle_name": "RENE",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-08-20",
"last_updated": "2015-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "70258",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lubbock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.