Individual provider Active NPI

Shana Koch, LPC

  • Professional Counselor
  • Milwaukee, WI
National Provider Identifier
1922737188
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
11741-125 Issued in WI
Practice address
10850 W Park PL Ste 100
Milwaukee, WI 53224-3636
Phone
(262) 999-3495
NPI assigned
Jun 5, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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 11741-125 WI Primary

Addresses

Primary practice location

10850 W Park PL Ste 100
Milwaukee, WI 53224-3636

Mailing address

4800 N Scottsdale Rd Ste 2500
Scottsdale, AZ 85251-7630
Phone (262) 999-3495

Other practice location 1

11414 W Park Place Suite 202
Milwaukee
Wi, WI 53224-3500
Phone (414) 439-2201

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
I20250702002184 WI Practitioner - Mental Health Counselor 9032622956 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11741-125WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Counseling Services, Inc CurrentSince Jul 14, 2025 Accepting new patients
Grow Healthcare Group PA Professional CurrentSince Jun 27, 2025 Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

4321 W College Ave
Ste 200
Appleton, WI 54914
Phone (920) 519-2920

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

Organizations & group practices 2

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": "1654387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1922737188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 N SCOTTSDALE RD STE 2500",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852517630",
            "telephone_number": "262-999-3495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10850 W PARK PL STE 100",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532243636",
            "telephone_number": "262-999-3495"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11414 W Park Place Suite 202",
            "address_2": "Milwaukee",
            "address_purpose": "LOCATION",
            "city": "WI",
            "state": "WI",
            "postal_code": "532243500",
            "country_code": "US",
            "telephone_number": "414-439-2201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOCH",
        "first_name": "SHANA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-05",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "11741-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.