Provider Demographics
NPI:1134875750
Name:SPEAK EASY TELETHERAPY, LLC
Entity type:Organization
Organization Name:SPEAK EASY TELETHERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:SAVAGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-315-7478
Mailing Address - Street 1:691 SHOAL CREEK DR
Mailing Address - Street 2:
Mailing Address - City:DEATSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36022-3486
Mailing Address - Country:US
Mailing Address - Phone:706-315-7478
Mailing Address - Fax:334-625-1532
Practice Address - Street 1:691 SHOAL CREEK DR
Practice Address - Street 2:
Practice Address - City:DEATSVILLE
Practice Address - State:AL
Practice Address - Zip Code:36022-3486
Practice Address - Country:US
Practice Address - Phone:706-315-7478
Practice Address - Fax:334-625-1532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-22
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty