Mackenzie Marie Pelke, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

1024870 Issued in MN

Practice address

2520 12TH Ave E
North St Paul, MN 55109-2420

Phone

(651) 748-7450

NPI assigned

Jun 28, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mackenzie Marie Goodreau Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Family Service Madison Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Madison, WI
  • NPI 1881806198
  NPD
• The Isd 622 Education Center

  • Local Education Agency (LEA)
  • North St. Paul, MN
  • NPI 1952462236
  NPD (past)
• Hhu Xtra Care Inc

  • Home Infusion Therapy Pharmacy
  • Madison, WI
  • NPI 1326337106
  NPD (past)

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

{
    "created_epoch": "1624838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776384000000",
    "number": "1902476435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 12TH AVE E",
            "city": "NORTH ST PAUL",
            "state": "MN",
            "postal_code": "551092420",
            "telephone_number": "651-748-7450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 12TH AVE E",
            "city": "NORTH ST PAUL",
            "state": "MN",
            "postal_code": "551092420",
            "telephone_number": "651-748-7450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELKE",
        "first_name": "MACKENZIE",
        "middle_name": "MARIE",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-28",
        "last_updated": "2026-04-17",
        "certification_date": "2026-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "1024870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WI DEPARTMENT OF SAFETY & PROFESSIONAL SERVICES",
            "identifier": "5234-154",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MACKENZIE",
            "last_name": "GOODREAU",
            "middle_name": "MARIE",
            "credential": "CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• North St. Paul Dental
• Allison Elizabeth O'Halloran, PMHNP
• Carrie Marie O'Rourke
• Jamie Laurich Omann, RN, CPNP
• Amber Marie Peifer, MA, MPS, LPCC
• Stephen Carl Perry, MSED LP
• Lisa Pietig, SLP
• Timothy Daniel Plant
• Polar Pharmacy and Medical Supplies
• Nate Quick

• Speech-Language Pathologist in North St Paul, MN
• Providers in North St Paul, MN by specialty
• Speech-Language Pathologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 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.