Individual provider Active NPI

Daniel Villarreal, LCSW

  • Clinical Social Worker
  • Sun Prairie, WI
National Provider Identifier
1053516013
Registry record updated Mar 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7251 Issued in WI
Practice address
722 Lois Dr
Sun Prairie, WI 53590-1100
Phone
(608) 837-9112
NPI assigned
Jun 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 7251 WI Primary

Addresses

Primary practice location

722 Lois Dr
Sun Prairie, WI 53590-1100

Mailing address

860 Garden Dr Apt 73
Sun Prairie, WI 53590-4178

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170830000605 WI Practitioner - Clinical Social Worker 1355614165 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cornerstone Counseling Services IncGroup PAC ID 1456256023, 338 clinicians

Practice addresses (Care Compare)

5315 Wall St
Suite 290
Madison, WI 53718-7965
Phone (608) 236-4460

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7251WIMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Clinical Current Accepting new patients
Trivium LLC PastSince Mar 9, 2020 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: danielvillarreal@tdh.allscriptsdirect.net

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583712000000",
    "number": "1053516013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 GARDEN DR APT 73",
            "city": "SUN PRAIRIE",
            "state": "WI",
            "postal_code": "535904178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 LOIS DR",
            "city": "SUN PRAIRIE",
            "state": "WI",
            "postal_code": "535901100",
            "telephone_number": "608-837-9112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLARREAL",
        "first_name": "DANIEL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-19",
        "last_updated": "2020-03-09",
        "certification_date": "2020-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun Prairie, WI

Sources for this page

Verify at the official NPI Registry.