Provider Demographics
NPI:1447630553
Name:KECK, ALICE ROSE
Entity type:Individual
Prefix:MS
First Name:ALICE
Middle Name:ROSE
Last Name:KECK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 SAN PEDRO DR NE STE 203
Mailing Address - Street 2:ARBOR COUNSELING, LLC
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-4122
Mailing Address - Country:US
Mailing Address - Phone:505-414-7721
Mailing Address - Fax:
Practice Address - Street 1:2741 INDIAN SCHOOL RD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-2653
Practice Address - Country:US
Practice Address - Phone:505-750-8866
Practice Address - Fax:707-444-8368
Is Sole Proprietor?:No
Enumeration Date:2015-06-03
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMC-31601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical