Provider Demographics
NPI:1043078991
Name:KECK COUNSELING
Entity Type:Organization
Organization Name:KECK COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:KECK
Authorized Official - Suffix:
Authorized Official - Credentials:PLADC
Authorized Official - Phone:153-177-2974
Mailing Address - Street 1:4923 DAVENPORT ST APT 2
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68132-2985
Mailing Address - Country:US
Mailing Address - Phone:153-177-2974
Mailing Address - Fax:
Practice Address - Street 1:1941 S 42ND ST STE 224
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68105-2946
Practice Address - Country:US
Practice Address - Phone:531-772-9749
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty