Ryan Sershon, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

8525 Issued in WI

Practice address

W175N11081 Stonewood Dr Ste 212
Germantown, WI 53022-4771

Phone

(262) 244-6177

NPI assigned

Mar 16, 2017

Last updated

Aug 25, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Clinical Social Worker

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cornerstone Counseling Services IncGroup PAC ID 1456256023, 338 clinicians

Mind Matters Psychological Services, S.C.Group PAC ID 8628505013, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lifestancehealth.ryansershon@149809.advancedmd-direct.com

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.

• Cornerstone Counseling Services, Inc

  dba LifeStance Health

  • Mental Health Counselor
  • Brookfield, WI
  • NPI 1033127246

  Addiction (Substance Use Disorder)

  Medicare reassignment Care Compare group NPD
• Mind Matters Psychological Services, S.C.

  • Clinical Psychologist
  • Mequon, WI
  • NPI 1891516472
  Medicare reassignment Care Compare group
• Waukesha Health System, Inc.

  dba Behavioral Medicine Center

  • Clinic/Center
  • Waukesha, WI
  • NPI 1346353695
  Medicare reassignment NPD
• Waukesha Health System, Inc

  dba ProHealth Pharmacy - Waukesha

  • Community/Retail Pharmacy
  • Waukesha, WI
  • NPI 1073528675
  NPD
• Waukesha Health System, Inc

  dba ProHealth Pharmacy-Mukwonago

  • Community/Retail Pharmacy
  • Mukwonago, WI
  • NPI 1932772605
  NPD

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

{
    "created_epoch": "1489622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1407397938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 W GLEN OAKS LN STE 110",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530923392",
            "telephone_number": "262-244-6178",
            "fax_number": "262-299-3040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W175N11081 STONEWOOD DR STE 212",
            "city": "GERMANTOWN",
            "state": "WI",
            "postal_code": "530224771",
            "telephone_number": "262-244-6177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERSHON",
        "first_name": "RYAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-16",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "15925",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "8525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "8525-123",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000677057",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anthony Scott
• Rebekah Jo Scott, PH.D., LP
• Morgan Segrin, PT, DPT, CLT
• Serene Solutions LLC
• Serenity Hospice Care, LLC
• Darci Shook-Woolley, PSY.D.
• Alan H Siggelkow, LCSW
• Rebecca Lynn Sigourney-Tennyck, MD
• Jamie W Simon, FNP, APNP
• Peeush Singhal, M.D.

• Clinical Social Worker in Germantown, WI
• Providers in Germantown, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; 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.