Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Shelby Wagner, MS, CCC-SLP

Individual provider Speech-Language Pathologist · NPI 1760976450

Shelby Wagner, MS, CCC-SLP is a Qualified Speech Language Pathologist in Kenosha, Wisconsin. Qualified in 2018, 8 years ago. Licensed in Texas and Wisconsin.

Years since qualifying
8
Licensed in
TX, WI
In the registry since
2018
Specialties on file
2
What do these letters mean?
MS — Master of Science
A graduate science degree.
CCC-SLP — Certificate of Clinical Competence in Speech-Language Pathology
A speech-language pathologist certified by ASHA.

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Practice location Address checks out

5219 88th Ave
Kenosha, WI 53144-7468
Phone: (262) 653-0850
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence 121280 (TX)
Speech-Language Pathologist Taxonomy 235Z00000X · Licence 4646-154 (WI)

Record details

NPI number1760976450
Entity typeIndividual (Type 1)
GenderFemale
Credentials MS , CCC-SLP
Sole proprietorNo
NPI enumeratedJune 18, 2018
Last updated in NPPESMay 19, 2026
Certification dateMay 19, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyQUALIFIED SPEECH LANGUAGE PATHOLOGIST
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Accepts Medicare assignment Not indicated

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