Provider Demographics
NPI:1164588612
Name:KEECH, DEBORAH ELLEN (LMHC)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:ELLEN
Last Name:KEECH
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:PO BOX 821
Mailing Address - Street 2:
Mailing Address - City:SOUTH LANCASTER
Mailing Address - State:MA
Mailing Address - Zip Code:01561-0821
Mailing Address - Country:US
Mailing Address - Phone:978-302-1008
Mailing Address - Fax:
Practice Address - Street 1:338 MAIN ST
Practice Address - Street 2:
Practice Address - City:SOUTH LANCASTER
Practice Address - State:MA
Practice Address - Zip Code:01561
Practice Address - Country:US
Practice Address - Phone:978-368-2296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6278101YM0800X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No251S00000XAgenciesCommunity/Behavioral Health