Provider Demographics
NPI:1326219544
Name:SPEAKS, JALANE (NCC, LPCC)
Entity Type:Individual
Prefix:
First Name:JALANE
Middle Name:
Last Name:SPEAKS
Suffix:
Gender:F
Credentials:NCC, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:278 BEITING LN
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:KY
Mailing Address - Zip Code:40456-6376
Mailing Address - Country:US
Mailing Address - Phone:606-256-5623
Mailing Address - Fax:606-256-5622
Practice Address - Street 1:278 BEITING LN
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:KY
Practice Address - Zip Code:40456-6376
Practice Address - Country:US
Practice Address - Phone:606-256-5623
Practice Address - Fax:606-256-5622
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-15
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY104817101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional