Provider Demographics
NPI:1851049498
Name:DESPAIN, RACHEL NOELLE (MA)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:NOELLE
Last Name:DESPAIN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 S 70TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-1568
Mailing Address - Country:US
Mailing Address - Phone:402-937-8323
Mailing Address - Fax:402-937-8324
Practice Address - Street 1:1600 S 70TH ST STE 200
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-1568
Practice Address - Country:US
Practice Address - Phone:402-937-8323
Practice Address - Fax:402-937-8324
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-14
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE12733101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health