Healthcare Provider Details

I. General information

NPI: 1629485156
Provider Name (Legal Business Name): SPEAK-EASY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2014
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 EL MERCADO PLZ
JEFFERSON CITY MO
65109-6822
US

IV. Provider business mailing address

1908 WHITNEY WOODS DR
JEFFERSON CITY MO
65101-2386
US

V. Phone/Fax

Practice location:
  • Phone: 573-680-4913
  • Fax: 888-977-2979
Mailing address:
  • Phone: 573-680-4913
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: DANIELLE SCHWARTZ
Title or Position: MEMBER / SPEECH PATHOLOGIST
Credential: MA, CCC-SLP
Phone: 573-680-4913