Healthcare Provider Details

I. General information

NPI: 1104700244
Provider Name (Legal Business Name): RACHEL DIANE WILBORN LMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2025
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8055 O ST STE 301
LINCOLN NE
68510-2564
US

IV. Provider business mailing address

8055 O ST STE 301
LINCOLN NE
68510-2564
US

V. Phone/Fax

Practice location:
  • Phone: 402-489-1834
  • Fax:
Mailing address:
  • Phone: 402-489-1834
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number14884
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMC61590556
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: