Active NPI
Shorehaven Behavioral Health Inc
- Child & Adolescent Psychiatry Physician
- Milwaukee, WI
National Provider Identifier
1598800740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- Legal business name
- SHOREHAVEN BEHAVIORAL HEALTH INC
- Practice address
- 8405 W Forest Home Av
Suite 104
Milwaukee, WI 53228 - Phone
- (414) 540-2170
- Fax
- (414) 540-2171
- NPI assigned
- Feb 21, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Don David Rosenberg, MS
- Title
- President
- Phone
- (414) 540-2170
Specialties & licenses 10
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Professional Counselor | 101YP2500X | |||
| Clinical Neuropsychologist | 103G00000X | |||
| Clinical Psychologist | 103TC0700X | |||
| Social Worker | 104100000X | |||
| Marriage & Family Therapist | 106H00000X | |||
| Psychiatry Physician | 2084P0800X | |||
| Child & Adolescent Psychiatry Physician | 2084P0804X | Primary | ||
| Art Therapist | 221700000X |
Addresses
Primary practice location
8405 W Forest Home Av
Suite 104
Milwaukee, WI 53228
Mailing address
3900 W Brown Deer Rd
Suite 200
Brown Deer, WI 53209
Phone (414) 540-2170
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070404000380 | WI | Part B Supplier - Clinic/Group Practice | 0143324954 |
Receives reassigned benefits from 25 practitioners 2 other NPIs on this enrollment Practice locations: Brown Deer, WI; Greenfield, WI; Mount Pleasant, WI |
Other NPIs on the same Medicare enrollment 2
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Clinical Neuropsychologist
- Waukesha, WI
- NPI 1265564678
O20070404000380
-
- Clinical Psychologist
- Brown Deer, WI
- NPI 1891887055
O20070404000380
National Provider Directory
National Provider DirectoryLocations
8405 W Forest Home Ave
Ste 104
Milwaukee, WI 53228
Practitioners & affiliated clinicians
Practitioners 26
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172016000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1757548800000",
"number": "1598800740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3900 W BROWN DEER RD",
"address_2": "SUITE 200",
"city": "BROWN DEER",
"state": "WI",
"postal_code": "53209",
"telephone_number": "414-540-2170",
"fax_number": "414-540-2171"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8405 W FOREST HOME AV",
"address_2": "SUITE 104",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "53228",
"telephone_number": "414-540-2170",
"fax_number": "414-540-2171"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SHOREHAVEN BEHAVIORAL HEALTH INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-21",
"last_updated": "2025-09-11",
"status": "A",
"authorized_official_last_name": "ROSENBERG",
"authorized_official_first_name": "DON",
"authorized_official_middle_name": "DAVID",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "414-540-2170",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "MS"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": false
},
{
"code": "103G00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Clinical Neuropsychologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Marriage & Family Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": null,
"license": null,
"primary": true
},
{
"code": "221700000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Art Therapist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.