Provider Demographics
NPI:1679173280
Name:WILLMS, RACHEL LYNN (LCMHC-A)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:LYNN
Last Name:WILLMS
Suffix:
Gender:F
Credentials:LCMHC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 W ILLINOIS AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTHERN PINES
Mailing Address - State:NC
Mailing Address - Zip Code:28387-5808
Mailing Address - Country:US
Mailing Address - Phone:910-692-2444
Mailing Address - Fax:
Practice Address - Street 1:195 W ILLINOIS AVE
Practice Address - Street 2:
Practice Address - City:SOUTHERN PINES
Practice Address - State:NC
Practice Address - Zip Code:28387-5808
Practice Address - Country:US
Practice Address - Phone:910-692-2444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-01
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA15901101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health