Individual provider Active NPI

Sadie Lynn Mleziva, MS CCC SLP

  • Speech-Language Pathologist
  • Luxemburg, WI
National Provider Identifier
1629270012
Registry record updated Mar 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2506154 Issued in WI
Practice address
318 N Main St
Luxemburg, WI 54217-1129
Phone
(920) 845-2371
NPI assigned
Jun 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2506154 WI Primary

Addresses

Primary practice location

318 N Main St
Luxemburg, WI 54217-1129

Mailing address

E700 JJ Rd
Luxemburg, WI 54217-7546
Phone (920) 422-2051

Other identifiers 1

IdentifierTypeStateIssuer
42802800MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2506154WIMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772668800000",
    "number": "1629270012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "E700 JJ RD",
            "city": "LUXEMBURG",
            "state": "WI",
            "postal_code": "542177546",
            "telephone_number": "920-422-2051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 N MAIN ST",
            "city": "LUXEMBURG",
            "state": "WI",
            "postal_code": "542171129",
            "telephone_number": "920-845-2371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MLEZIVA",
        "first_name": "SADIE",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "MS CCC SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-05",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "2506154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42802800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Luxemburg, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2026; 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.