MEDICARE: MRS. ANGELA KECK LCPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	0701011596	VA
2	101YM0800X	Mental Health Counselor	LGP4881	MD
3	101YP2500X	Professional Counselor	LC10451	MD

General Provider Information

NPI Number	:	1467087023
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANGELA KECK LCPC

Provider Business Mailing Address
First Line	:	1145 OLD WESTMINSTER PIKE
Second Line	:
City	:	WESTMINSTER
State	:	MD
Zip	:	21157-7014
Country	:	US
Telephone Number	:	410-861-0167
Fax Number	:

Provider Business Practice Location Address
First Line	:	1145 OLD WESTMINSTER PIKE
Second Line	:
City	:	WESTMINSTER
State	:	MD
Zip	:	21157-7014
Country	:	US
Telephone Number	:	410-861-0167
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/04/2020
Last Update Date	:	01/28/2026

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