Provider Demographics
NPI:1144360488
Name:KECK, MATT (MFT)
Entity type:Individual
Prefix:
First Name:MATT
Middle Name:
Last Name:KECK
Suffix:
Gender:M
Credentials:MFT
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 371420
Mailing Address - Street 2:
Mailing Address - City:MONTARA
Mailing Address - State:CA
Mailing Address - Zip Code:94037-1420
Mailing Address - Country:US
Mailing Address - Phone:650-556-4565
Mailing Address - Fax:650-704-0034
Practice Address - Street 1:1400 TEMPLE ST.
Practice Address - Street 2:
Practice Address - City:MONTARA
Practice Address - State:CA
Practice Address - Zip Code:94037
Practice Address - Country:US
Practice Address - Phone:650-556-4565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health