Provider Demographics
NPI:1245983659
Name:SPEAKING TRAUMA, PLLC
Entity type:Organization
Organization Name:SPEAKING TRAUMA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAKACS
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:564-210-7035
Mailing Address - Street 1:4548 CHANTING CIR SW
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98367-6224
Mailing Address - Country:US
Mailing Address - Phone:564-210-7035
Mailing Address - Fax:
Practice Address - Street 1:4548 CHANTING CIR SW
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98367-6224
Practice Address - Country:US
Practice Address - Phone:564-210-7035
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-27
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health