MEDICARE: REBECCA SUSAN HECK M.ED.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor
2	101YM0800X	Mental Health Counselor	2007034624	MO
3	101YP2500X	Professional Counselor	180.003290	IL
4	101YP2500X	Professional Counselor	2007034624	MO

General Provider Information

NPI Number	:	1932354800
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA SUSAN HECK M.ED.

Provider Business Mailing Address
First Line	:	10844 SAINT FRANCIS LN
Second Line	:
City	:	SAINT ANN
State	:	MO
Zip	:	63074-3414
Country	:	US
Telephone Number	:	314-603-7809
Fax Number	:

Provider Business Practice Location Address
First Line	:	4801 WELDON SPRING PKWY
Second Line	:
City	:	WELDON SPRING
State	:	MO
Zip	:	63304-9101
Country	:	US
Telephone Number	:	636-441-7300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/19/2008
Last Update Date	:	05/19/2020

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