Individual
KYLE BLAIN KECKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IMFT, LPCC
Contact information
Practice address
195 N GRANT AVE STE 250, COLUMBUS, OH 43215-2855
(888) 522-9174
(614) 928-9092
Mailing address
434 EASTLAND RD, BEREA, OH 44017-1217
(440) 260-8327
(440) 234-8319
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
E1901016
OH
106H00000X
Marriage & Family Therapist
Primary
F.1700025
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F.1700025
IMFT
OH
Enumeration date
10/13/2017
Last updated
02/25/2020
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