Organization Active NPI

Speakeasy Clinic

  • Speech-Language Pathologist
  • Pascagoula, MS
National Provider Identifier
1649933250
Registry record updated Feb 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
SPEAKEASY CLINIC
Practice address
1511 Jackson Ave
Pascagoula, MS 39567-4356
Phone
(228) 219-4793
Fax
(228) 533-2324
NPI assigned
Oct 20, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2026

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

Authorized official

Name
Ms. Terral Latady, M.S. CCC-SLPNPI 1174047302
Title
Speech-Language Pathologist
Phone
(228) 219-4793

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

1511 Jackson Ave
Pascagoula, MS 39567-4356

Mailing address

1511 Jackson Ave
Pascagoula, MS 39567-4356
Phone (228) 219-4793

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211209001799 MS Part B Supplier - Clinic/Group Practice 5092105858 Receives reassigned benefits from 2 practitioners
Practice locations: Pascagoula, MS

National Provider Directory

National Provider Directory

Locations

1511 Jackson Ave
Pascagoula, MS 39567
Phone (228) 249-9449

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1634688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772064000000",
    "number": "1649933250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1511 JACKSON AVE",
            "city": "PASCAGOULA",
            "state": "MS",
            "postal_code": "395674356",
            "telephone_number": "228-219-4793",
            "fax_number": "228-533-2324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 JACKSON AVE",
            "city": "PASCAGOULA",
            "state": "MS",
            "postal_code": "395674356",
            "telephone_number": "228-219-4793",
            "fax_number": "228-533-2324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPEAKEASY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-20",
        "last_updated": "2026-02-26",
        "certification_date": "2026-02-26",
        "status": "A",
        "authorized_official_last_name": "LATADY",
        "authorized_official_first_name": "TERRAL",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "228-219-4793",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.S. CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pascagoula, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.