Kelly L. Waliszek, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP2634 Issued in ME

Practice address

10 Old Quarry Rd
Cape Neddick, ME 03902-7505

Phone

(603) 343-8965

NPI assigned

Mar 20, 2007

Last updated

May 29, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1376668517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 OLD QUARRY RD",
            "city": "CAPE NEDDICK",
            "state": "ME",
            "postal_code": "039027505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 OLD QUARRY RD",
            "city": "CAPE NEDDICK",
            "state": "ME",
            "postal_code": "039027505",
            "telephone_number": "603-343-8965"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Child Development Services 146 State House Station",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "ME",
            "postal_code": "043334612",
            "country_code": "US",
            "telephone_number": "207-624-6660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALISZEK",
        "first_name": "KELLY",
        "middle_name": "L.",
        "name_prefix": "Miss",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NH",
            "license": "1117",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ME",
            "license": "SP2634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edmund G Lowrie, M.D.
• Paul Welch LCSW LLC
• Maura Sullivan Reed, LCPC-C
• Meghan E Roberts, OTR/L
• Michael R Voth, M.D.
• Paul J Welch, LCSW

• Speech-Language Pathologist in Cape Neddick, ME
• Providers in Cape Neddick, ME by specialty
• Speech-Language Pathologist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.