Provider Demographics
NPI:1861745051
Name:KECK, JULIE CRAWFORD (LPC)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:CRAWFORD
Last Name:KECK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2817 INGLESIDE DR
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-3795
Mailing Address - Country:US
Mailing Address - Phone:706-414-6811
Mailing Address - Fax:
Practice Address - Street 1:3665 WHEELER RD STE 1A
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-6596
Practice Address - Country:US
Practice Address - Phone:706-250-3902
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-25
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH 10152101YM0800X
101YM0800X
GALPC009005101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health