Provider Demographics
NPI:1245033612
Name:SPEAKS, TESSA KELAN
Entity type:Individual
Prefix:
First Name:TESSA
Middle Name:KELAN
Last Name:SPEAKS
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 1:17 M ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02127-2395
Mailing Address - Country:US
Mailing Address - Phone:203-400-9822
Mailing Address - Fax:
Practice Address - Street 1:9 POND LN STE 4D
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-2842
Practice Address - Country:US
Practice Address - Phone:203-400-9822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health