Individual provider Active NPI

Mykalea Gonzalez, CCC-SLP

  • Speech-Language Pathologist
  • Milwaukee, WI
National Provider Identifier
1205724978
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
14416375 Issued in WI
Practice address
5378 N Green Bay Ave
Milwaukee, WI 53209-5060
Phone
(414) 430-9309
NPI assigned
Jun 24, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 14416375 WI Primary

Addresses

Primary practice location

5378 N Green Bay Ave
Milwaukee, WI 53209-5060

Mailing address

5378 N Green Bay Ave
Milwaukee, WI 53209-5060
Phone (414) 430-9309

Other names 1

  • Mykalea Dycus Former name

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
14416375WIMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1750723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1205724978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5378 N GREEN BAY AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532095060",
            "telephone_number": "414-430-9309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5378 N GREEN BAY AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532095060",
            "telephone_number": "414-430-9309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "MYKALEA",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-24",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "14416375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MYKALEA",
            "last_name": "DYCUS",
            "credential": "N/A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; 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.