Sharon S Fedderly, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1452-57 Issued in WI

Practice address

5900 N. Port Washington Rd Suite 230
Glendale, WI 53217

Phone

(414) 962-4048

Fax

(414) 962-4052

NPI assigned

Oct 5, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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 Psychologist

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Cornerstone Counseling Services IncGroup PAC ID 1456256023, 338 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lifestancehealth.sharonfedderly@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 and National Provider Directory roles.

• Cornerstone Counseling Services, Inc

  dba LifeStance Health

  • Mental Health Counselor
  • Brookfield, WI
  • NPI 1033127246
  Medicare reassignment Care Compare group NPD
• Shore Counseling and Consulting Clinic, S.C.

  • Group Psychotherapy Psychologist
  • Milwaukee, WI
  • NPI 1588710073
  NPD (past)

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766448000000",
    "number": "1619064441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 N. PORT WASHINGTON RD SUITE 230",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "53217",
            "telephone_number": "414-962-4048",
            "fax_number": "414-962-4052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 N. PORT WASHINGTON RD SUITE 230",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "53217",
            "telephone_number": "414-962-4048",
            "fax_number": "414-962-4052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDDERLY",
        "first_name": "SHARON",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "1452-057",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "1452-57",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Exodus Counseling Center, Inc.
• Eye Care Optical (Specs Appeal)
• Eyeguyz I, LTD. (Pearle Vision)
• Families of Hope
• Family Ties Prenatal Care LLC
• Benjamin H Fendrich, LCSW, CSAC
• Randi Rose Fennig
• Anthony Arlo Ferguson, MD
• Joanne Fetting, OTR
• Thomas A. Fiedler, DDS

• Clinical Psychologist in Glendale, WI
• Providers in Glendale, WI by specialty
• Clinical Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2025; 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.