Individual provider Active NPI

Lucie Rebecca Keena, COTA/L

  • Occupational Therapy Assistant
  • West Frankfort, IL
National Provider Identifier
1114714631
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
057.006063 Issued in IL
Practice address
4640 Pacific Dr
West Frankfort, IL 62896-4245
Phone
(618) 440-1451
NPI assigned
Apr 21, 2025
Last updated
Apr 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 057.006063 IL Primary

Addresses

Primary practice location

4640 Pacific Dr
West Frankfort, IL 62896-4245

Mailing address

4640 Pacific Dr
West Frankfort, IL 62896-4245
Phone (618) 440-1451

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
057.006063ILMDOccupational Therapy Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1745193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745193600000",
    "number": "1114714631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4640 PACIFIC DR",
            "city": "WEST FRANKFORT",
            "state": "IL",
            "postal_code": "628964245",
            "telephone_number": "618-440-1451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4640 PACIFIC DR",
            "city": "WEST FRANKFORT",
            "state": "IL",
            "postal_code": "628964245",
            "telephone_number": "618-440-1451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEENA",
        "first_name": "LUCIE",
        "middle_name": "REBECCA",
        "name_prefix": "Ms.",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-21",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IL",
            "license": "057.006063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Frankfort, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.