Individual provider Active NPI

Rebecca Lynn Keck

  • Mental Health Counselor
  • Orlando, FL
National Provider Identifier
1508452913
Registry record updated Feb 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH21563 Issued in FL
Practice address
5401 S Kirkman Rd Ste 229
Orlando, FL 32819-7940
Phone
(407) 917-0874
NPI assigned
Dec 19, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X IMH20165 FL
Mental Health Counselor 101YM0800X MH21563 FL Primary

Addresses

Primary practice location

5401 S Kirkman Rd Ste 229
Orlando, FL 32819-7940

Mailing address

5401 S Kirkman Rd Ste 229
Orlando, FL 32819-7940
Phone (407) 917-0874

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
IMH20165FLMDMental Health Counselor
MH21563FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Embrace Authenticity Counseling, LLC Mental Health CurrentSince Oct 8, 2023 Accepting new patients
Embrace Authenticity Counseling, LLC Mental Health CurrentSince Feb 19, 2023 Accepting new patients

Locations

5401 S Kirkman Rd
Ste 229
Orlando, FL 32819
Phone (407) 917-0874

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1608336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676678400000",
    "number": "1508452913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 S KIRKMAN RD STE 229",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328197940",
            "telephone_number": "407-917-0874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 S KIRKMAN RD STE 229",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328197940",
            "telephone_number": "407-917-0874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KECK",
        "first_name": "REBECCA",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-19",
        "last_updated": "2023-02-18",
        "certification_date": "2023-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH20165",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH21563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2023; 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.