Provider Demographics
NPI:1235996786
Name:SPEAK EASY MENTAL HEALTH SERVICES
Entity Type:Organization
Organization Name:SPEAK EASY MENTAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:RAQUEL
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:443-797-2364
Mailing Address - Street 1:439 LAUREL OAK LN
Mailing Address - Street 2:
Mailing Address - City:SEVEN VALLEYS
Mailing Address - State:PA
Mailing Address - Zip Code:17360-8721
Mailing Address - Country:US
Mailing Address - Phone:443-797-2364
Mailing Address - Fax:443-267-0084
Practice Address - Street 1:2415 W LAFAYETTE AVE STE D
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21216-4804
Practice Address - Country:US
Practice Address - Phone:410-793-4777
Practice Address - Fax:443-267-0084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-01
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health