Provider Demographics
NPI:1992687529
Name:SPEAK EASY ONLINE
Entity type:Organization
Organization Name:SPEAK EASY ONLINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERSON-FATINO
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:417-781-4552
Mailing Address - Street 1:PO BOX 62
Mailing Address - Street 2:
Mailing Address - City:BOLIVAR
Mailing Address - State:MO
Mailing Address - Zip Code:65613-0062
Mailing Address - Country:US
Mailing Address - Phone:417-781-4552
Mailing Address - Fax:417-777-7017
Practice Address - Street 1:5202 MCCLELLAND BLVD
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:65804
Practice Address - Country:US
Practice Address - Phone:417-781-4552
Practice Address - Fax:417-777-7017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-24
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO498031608Medicaid