SPEAK EASY LLC


Address: 10 Nw 5th St Ste 203, Grand Rapids, MN 55744-2660
Phone: 2182455073

SPEAK EASY LLC (NPI# 1881154953) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1881154953
Entity Type Organization
Organization Name SPEAK EASY LLC
Practice Address 10 Nw 5th St Ste 203
Grand Rapids
MN 55744-2660
Practice Telephone 2182455073
Mailing Telephone 2182455073
Enumeration Date 2019-03-23
Last Update Date 2019-03-23
Authorized Official Name MELISSA KAY REYNOLDS WEIDENDORF (OWNER)
Authorized Official Telephone 2182455073
Authorized Official Credential LPCC
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QM0801X Clinic/Center
Specialization: Mental Health (Including Community Mental Health Center)
Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
NPI 1 1619484862 01

Office Location

Street Address 10 NW 5TH ST STE 203
City GRAND RAPIDS
State MN
Zip Code 55744-2660

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Taxonomy Information

Taxonomy Code 261QM0801X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Mental Health (Including Community Mental Health Center)

Taxonomy Definition

Definition to come...

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Competitor

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City GRAND RAPIDS
Zip Code 55744

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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