Healthcare Provider Details

I. General information

NPI: 1295699916
Provider Name (Legal Business Name): WHITNEY WILLBORN LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8275 JUDGES WAY #100I
FRISCO TX
75036
US

IV. Provider business mailing address

6017 MENDOTA DR
PLANO TX
75024-6010
US

V. Phone/Fax

Practice location:
  • Phone: 806-773-5939
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number109813
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: