Individual provider Active NPI

Shannon Colleen Huff, ED.S.

  • Psychologist
  • Wausau, WI
National Provider Identifier
1104166305
Registry record updated Sep 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
885-58 Issued in WI
Practice address
630 S 36TH Ave
Wausau, WI 54401-3930
Phone
(715) 842-9500
Fax
(715) 848-0425
NPI assigned
Feb 25, 2013
Last updated
Sep 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 885-58 WI Primary

Addresses

Primary practice location

630 S 36TH Ave
Wausau, WI 54401-3930

Mailing address

531 3Rd St S
Wisconsin Rapids, WI 54494
Phone (715) 323-6856

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
I20240729000602 WI Practitioner - Clinical Psychologist 0143766956 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Behavioral Health Clinic LLCGroup PAC ID 8628409885, 43 clinicians

Practice addresses (Care Compare)

630 S 36TH Ave
Wausau, WI 54401-3930
Phone (715) 842-9500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
885-58WIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Health Clinic, LLC Psychologist CurrentSince Jul 16, 2024 Accepting new patients

Locations

2417 Post Rd
Stevens Point, WI 54481
Phone (715) 544-6144

630 S 36th Ave
Wausau, WI 54401
Phone (414) 301-1060

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1361750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789344000000",
    "number": "1104166305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 3RD ST S",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "54494",
            "telephone_number": "715-323-6856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 S 36TH AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544013930",
            "telephone_number": "715-842-9500",
            "fax_number": "715-848-0425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUFF",
        "first_name": "SHANNON",
        "middle_name": "COLLEEN",
        "credential": "ED.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-25",
        "last_updated": "2026-09-14",
        "certification_date": "2026-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "885-58",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

Verify at the official NPI Registry.