Organization Active NPI

Speakeasy Therapies & Fitness LLC

  • Speech-Language Pathologist
  • Maplewood, MO
National Provider Identifier
1326744467
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
SPEAKEASY THERAPIES & FITNESS LLC
Practice address
2718 Sutton Blvd
Maplewood, MO 63143-3036
Phone
(314) 246-0751
Fax
(314) 754-9926
NPI assigned
Jan 31, 2023
Last updated
Apr 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Celia G Montes-Kolence, MS-CCC, SLPNPI 1871989590
Title
Owner
Phone
(314) 348-7327

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X NU
Speech-Language Pathologist 235Z00000X NU Primary

Addresses

Primary practice location

2718 Sutton Blvd
Maplewood, MO 63143-3036

Mailing address

2718 Sutton Blvd
Saint Louis, MO 63143-3036
Phone (314) 348-7327

Other identifiers 1

IdentifierTypeStateIssuer
M53210784658MedicaidMO

National Provider Directory

National Provider Directory

Locations

12213 Big Bend Rd
Saint Louis, MO 63122
Phone (314) 246-0751

2718 Sutton Blvd
Saint Louis, MO 63143
Phone (314) 246-0751

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1675123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712188800000",
    "number": "1326744467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2718 SUTTON BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631433036",
            "telephone_number": "314-348-7327",
            "fax_number": "314-754-9926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2718 SUTTON BLVD",
            "city": "MAPLEWOOD",
            "state": "MO",
            "postal_code": "631433036",
            "telephone_number": "314-246-0751",
            "fax_number": "314-754-9926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPEAKEASY THERAPIES & FITNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-31",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A",
        "authorized_official_last_name": "MONTES-KOLENCE",
        "authorized_official_first_name": "CELIA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-348-7327",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS-CCC, SLP"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "M53210784658",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.