Individual provider Active NPI

Nerissa Seabrook, CCC-SLP

  • Speech-Language Pathologist
  • Kewaskum, WI
National Provider Identifier
1972453140
Registry record updated Jan 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
14149013 Issued in WI
Practice address
1455 School St
Kewaskum, WI 53040-8924
Phone
(262) 626-8427
NPI assigned
Jan 29, 2026
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 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 14149013 WI Primary

Addresses

Primary practice location

1455 School St
Kewaskum, WI 53040-8924

Mailing address

4556 N 107TH St
Wauwatosa, WI 53225-4527
Phone (414) 243-4662

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

State licenses

LicenseStateTypeSpecialty
14149013WIMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1769644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769644800000",
    "number": "1972453140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4556 N 107TH ST",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532254527",
            "telephone_number": "414-243-4662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 SCHOOL ST",
            "city": "KEWASKUM",
            "state": "WI",
            "postal_code": "530408924",
            "telephone_number": "262-626-8427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEABROOK",
        "first_name": "NERISSA",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2026-01-29",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "14149013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kewaskum, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 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.