Healthcare Provider Details

I. General information

NPI: 1093050775
Provider Name (Legal Business Name): MATTHEW J.A. MCKEE MA, LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/06/2012
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 CENTENNIAL ST.
GENEVA OH
44041
US

IV. Provider business mailing address

PO BOX 1097
ASHTABULA OH
44005-1097
US

V. Phone/Fax

Practice location:
  • Phone: 440-855-0204
  • Fax: 440-855-0089
Mailing address:
  • Phone: 440-855-0204
  • Fax: 440-855-0089

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.1100190
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: