Individual provider Active NPI

Sandra Henke

  • Professional Counselor
  • Mequon, WI
National Provider Identifier
1447803465
Registry record updated Jan 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
5713-125 Issued in WI
Practice address
11518 N Port Washington Rd Ste 202
Mequon, WI 53092-3443
Phone
(262) 244-6177
NPI assigned
Jul 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 5713-125 WI Primary

Addresses

Primary practice location

11518 N Port Washington Rd Ste 202
Mequon, WI 53092-3443

Mailing address

1035 W Glen Oaks LN Ste 110
Mequon, WI 53092-3392

Other identifiers 1

IdentifierTypeStateIssuer
100091146MedicaidWI

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
I20240202000774 WI Practitioner - Mental Health Counselor 8224481577 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Counseling Services, Inc CurrentSince Mar 1, 2024 Accepting new patients

Locations

16535 W Bluemound Rd
Ste 200
Brookfield, WI 53005
Phone (262) 789-0909

11649 N Port Washington Rd
Ste 201
Mequon, WI 53092
Phone 2627891191380

1035 W Glen Oaks Ln
Ste 110
Mequon, WI 53092
Phone (262) 240-0299

11649 N Port Washington Rd
Ste 221
Mequon, WI 53092
Phone (262) 912-1922

11518 N Port Washington Rd
Ste 202
Mequon, WI 53092
Phone (262) 244-6177

10850 W Park Pl
Ste 100
Milwaukee, WI 53224
Phone (414) 361-4100

Interoperability endpoints

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1563408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1447803465",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11518 N PORT WASHINGTON RD STE 202",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530923443",
            "telephone_number": "262-244-6177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENKE",
        "first_name": "SANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-18",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "5713-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100091146",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mequon, WI

Sources for this page

Verify at the official NPI Registry.