Individual provider Active NPI

Paul Villarreal, MS CCC-SLP

  • Speech-Language Pathologist
  • Deforest, WI
National Provider Identifier
1205759750
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1001462920 Issued in WI
Practice address
500 S Cleveland Ave
Deforest, WI 53532-1618
Phone
(608) 842-6500
NPI assigned
Aug 3, 2026
Last updated
Aug 3, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 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 1001462920 WI Primary

Addresses

Primary practice location

500 S Cleveland Ave
Deforest, WI 53532-1618

Mailing address

550 Seminole Way
Deforest, WI 53532-3014
Phone (608) 535-0969

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1001462920WIMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1785715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785715200000",
    "number": "1205759750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 SEMINOLE WAY",
            "city": "DEFOREST",
            "state": "WI",
            "postal_code": "535323014",
            "telephone_number": "608-535-0969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S CLEVELAND AVE",
            "city": "DEFOREST",
            "state": "WI",
            "postal_code": "535321618",
            "telephone_number": "608-842-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLARREAL",
        "first_name": "PAUL",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-08-03",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "1001462920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deforest, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 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.