Provider Demographics
NPI:1043669708
Name:WHETTEN, RACHEL (MSW, MPH)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:WHETTEN
Suffix:
Gender:F
Credentials:MSW, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 W POPLAR AVE APT E3
Mailing Address - Street 2:
Mailing Address - City:CARRBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27510-1660
Mailing Address - Country:US
Mailing Address - Phone:919-619-0891
Mailing Address - Fax:
Practice Address - Street 1:3622 LYCKAN PKWY STE 6005
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-2500
Practice Address - Country:US
Practice Address - Phone:919-619-0891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-03
Last Update Date:2018-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCPO105201041C0700X
NCC0115061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical