Intentional Psychology LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

INTENTIONAL PSYCHOLOGY LLC

Practice address

N14W23777 Stone Ridge Dr Ste 135
Waukesha, WI 53188-1164

Phone

(414) 279-9082

Fax

(414) 501-4399

NPI assigned

Jun 5, 2023

Organization subpart

No

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

Authorized official

Name

Shanna R Thomsen, CLINICAL PSYCHOLOGYNPI 1417438250

Title

Owner

Phone

(414) 279-9082

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shanna Rose Thomsen

  • Clinical Psychologist
  • Waukesha, WI
  • NPI 1417438250
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1685923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776988800000",
    "number": "1699469411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N14W23777 STONE RIDGE DR STE 135",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531881164",
            "telephone_number": "414-279-9082",
            "fax_number": "414-501-4399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N14W23777 STONE RIDGE DR STE 135",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531881164",
            "telephone_number": "414-279-9082",
            "fax_number": "414-501-4399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTENTIONAL PSYCHOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-05",
        "last_updated": "2026-04-24",
        "certification_date": "2026-04-24",
        "status": "A",
        "authorized_official_last_name": "THOMSEN",
        "authorized_official_first_name": "SHANNA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "414-279-9082",
        "authorized_official_credential": "CLINICAL PSYCHOLOGY"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2026; 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.

Verify at the official NPI Registry.