Provider Demographics
NPI:1134252539
Name:ECK, SHIRLEY KAY (LMHC)
Entity type:Individual
Prefix:MRS
First Name:SHIRLEY
Middle Name:KAY
Last Name:ECK
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7450 DR PHILLIPS BLVD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-5119
Mailing Address - Country:US
Mailing Address - Phone:407-489-3941
Mailing Address - Fax:407-291-3532
Practice Address - Street 1:5012 SPRING RUN AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-3332
Practice Address - Country:US
Practice Address - Phone:407-489-3941
Practice Address - Fax:407-291-3532
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH0006105101YM0800X
FLMH6105101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health