Provider Demographics
NPI:1134009889
Name:FLANAGAN, KACEY MARGARET
Entity type:Individual
Prefix:
First Name:KACEY
Middle Name:MARGARET
Last Name:FLANAGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3957 REGALWAY DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63129-1549
Mailing Address - Country:US
Mailing Address - Phone:314-686-2456
Mailing Address - Fax:
Practice Address - Street 1:2901 HIGH RIDGE BLVD
Practice Address - Street 2:
Practice Address - City:HIGH RIDGE
Practice Address - State:MO
Practice Address - Zip Code:63049-2212
Practice Address - Country:US
Practice Address - Phone:636-677-3996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-04
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2025028895235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist