Shannon Broeker, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

11969-125 Issued in WI

Practice address

1317 W Grand Ave Ste 6
Port Washington, WI 53074-2075

Phone

(262) 427-8905

NPI assigned

Jun 19, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Specialty

Mental Health Counselor

Education

Other, 2023

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)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Cornerstone Counseling Services, Inc

  • Mental Health Counselor
  • Brookfield, WI
  • NPI 1033127246
  Medicare reassignment Care Compare group NPD
• Forward Choices, LLC

  • Mental Health Counselor
  • Milwaukee, WI
  • NPI 1275791485
  NPD (past)

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

{
    "created_epoch": "1718755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768262400000",
    "number": "1386488955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 N SCOTTSDALE RD STE 2500",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852517630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 W GRAND AVE STE 6",
            "city": "PORT WASHINGTON",
            "state": "WI",
            "postal_code": "530742075",
            "telephone_number": "262-427-8905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROEKER",
        "first_name": "SHANNON",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-19",
        "last_updated": "2026-01-13",
        "certification_date": "2026-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "11969-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COUNSELOR",
            "identifier": "11969",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF WISONSIN",
            "identifier": "7529",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATEOFWISCONSIN",
            "identifier": "11969",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Teresa Lin Braun, MS, CCC-SLP
• Heather Kay Brede
• Emily Brennan
• Laura G. Brewer, PSYD
• Broadstep-Wisconsin, Inc.
• Crystal Ann Brooks, DDS
• Phillip L. Brooks, D.C.
• Christine Ann Brzakala, APNP
• Ashley Loren Buckmaster, APSW
• Andrew W Bunn, RN

• Professional Counselor in Port Washington, WI
• Providers in Port Washington, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.