Shane Leach, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

12713-123 Issued in WI

Practice address

5555 N Port Washington Rd Ste 200
Glendale, WI 53217-4927

Phone

(262) 999-3495

Fax

(262) 821-6180

NPI assigned

Mar 30, 2026

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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 Social Worker

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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 NPD

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

{
    "created_epoch": "1774828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777939200000",
    "number": "1861332827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 N PORT WASHINGTON RD STE 200",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532174927",
            "telephone_number": "262-999-3495",
            "fax_number": "262-821-6180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 N PORT WASHINGTON RD STE 200",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532174927",
            "telephone_number": "262-999-3495",
            "fax_number": "262-821-6180"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5650 N Green Bay Ave Ste 205",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "WI",
            "postal_code": "532094446",
            "country_code": "US",
            "telephone_number": "855-914-2881",
            "fax_number": "414-921-5652",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEACH",
        "first_name": "SHANE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-03-30",
        "last_updated": "2026-05-05",
        "certification_date": "2026-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "12713-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Lathers, LPC, CSAC, ICS
• Melissa A. Lauters, APNP
• Ruth Lawrence, M.S., CF-SLP
• Christine T Le Grand, LPC, ATRL-BC
• Christine Le, PHARMD.
• Linda Lee, LPC
• Maijer Lee
• Abby Leigh Leetzow, D.P.T.
• Megan Nicole Hunjadi Legros, DDS
• Lending Hands Healthcare, Inc.

• Clinical Social Worker in Glendale, WI
• Providers in Glendale, 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 May 5, 2026; 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.