Gary L. Keck, MS, LIMHP, CPC, LADC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

1903 Issued in NE

Practice address

502 W 2ND St
Grand Island, NE 68801-5938

Phone

(308) 379-4040

NPI assigned

Dec 11, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NE

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 1996

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442

  NE, Professional

  Medicare reassignment NPD

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288051200000",
    "number": "1881754620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4918 MERRICK AVE",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688019038",
            "telephone_number": "308-381-2823",
            "fax_number": "308-385-5522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 W 2ND ST",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688015938",
            "telephone_number": "308-379-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KECK",
        "first_name": "GARY",
        "middle_name": "L.",
        "name_prefix": "Mr.",
        "credential": "MS, LIMHP, CPC, LADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2010-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NE",
            "license": "433",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "1903",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NE",
            "license": "1108",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "691",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025305100",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chad Keezer, MS, PLMHP
• Khloe Grace Keezer, CNA
• Keg Surgical Assisting, LLC
• Michael Keiser

• Mental Health Counselor in Grand Island, NE
• Providers in Grand Island, NE by specialty
• Mental Health Counselor in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.