Individual provider Active NPI

Shanon E Heid, LPC

  • Professional Counselor
  • Menasha, WI
National Provider Identifier
1376359927
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
11220 Issued in WI
Practice address
1095 Midway Rd
Menasha, WI 54952-1115
Phone
(920) 740-6526
NPI assigned
Dec 9, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 11220 WI
Professional Counselor 101YP2500X 11220 WI Primary

Addresses

Primary practice location

1095 Midway Rd
Menasha, WI 54952-1115

Mailing address

1095 Midway Rd
Menasha, WI 54952-1115
Phone (920) 740-6526

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
I20250415003143 WI Practitioner - Mental Health Counselor 2668997370 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Thedacare, IncorporatedGroup PAC ID 1759294887, 654 clinicians

Practice addresses (Care Compare)

1095 Midway Rd
Menasha, WI 54952-1115
Phone (920) 720-2300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11220WIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Amanda Donath Psychological Services S C Professional CurrentSince Jun 1, 2026 Accepting new patients
Thedacare, Incorporated CurrentSince Feb 10, 2025 Accepting new patients
Thedacare, Incorporated Mental Health CurrentSince Feb 10, 2025 Accepting new patients

Locations

101 W Edison Ave
Ste 246
Appleton, WI 54915
Phone (262) 226-2006

1818 N Meade St
Appleton, WI 54911
Phone (920) 731-4101

1095 Midway Rd
Menasha, WI 54952
Phone (920) 720-3700

3 Neenah Ctr
Neenah, WI 54956
Phone (920) 454-4229

712 Summit Ave
Oconomowoc, WI 53066
Phone (262) 226-2006

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": "1733702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1376359927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1095 MIDWAY RD",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549521115",
            "telephone_number": "920-740-6526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1095 MIDWAY RD",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549521115",
            "telephone_number": "920-740-6526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEID",
        "first_name": "SHANON",
        "middle_name": "E",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-09",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "11220",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "11220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menasha, WI

Sources for this page

Verify at the official NPI Registry.