Individual provider Active NPI

John Lewis Rocha II, LCSW

  • Clinical Social Worker
  • Kenosha, WI
National Provider Identifier
1962912287
Registry record updated Jul 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11992-123 Issued in WI
Practice address
4006 Washington Rd
Kenosha, WI 53144-4819
Phone
(262) 656-0044
NPI assigned
Oct 2, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 11992-123 WI Primary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 149.019738 IL

Addresses

Primary practice location

4006 Washington Rd
Kenosha, WI 53144-4819

Mailing address

4006 Washington Rd
Kenosha, WI 53144-4819
Phone (262) 656-0044

Other practice location 1

903 S 2nd St
Silver Lake, WI 53170-1747
Phone (262) 771-3558

Other practice location 2

930 Dr Martin Luther King Dr
Racine, WI 53404-3008
Phone (262) 771-3558

Other practice location 3

4536 22nd Ave
Kenosha, WI 53140-5917
Phone (262) 656-0044

Other practice location 4

6226 14th Ave
Kenosha, WI 53143-4413
Phone (262) 656-0044

Other identifiers 1

IdentifierTypeStateIssuer
100285135MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20171215000154 IL Practitioner - Clinical Social Worker 3779841036 Reassigns benefits to 1 organization
I20241016003198 WI Practitioner - Clinical Social Worker 3779841036 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
149.019738ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Harbor Shore Wellness PLLC Clinical CurrentSince Apr 6, 2023 Accepting new patients
Kenosha Community Health Center, Inc CurrentSince Jul 18, 2024 Accepting new patients
County of Lake CurrentSince Aug 20, 2023 Accepting new patients
County of Lake Single Specialty Current Accepting new patients
Kenosha Community Health Center, Inc. CurrentSince Jul 18, 2024 Accepting new patients
County of Lake CurrentSince Aug 20, 2023 Accepting new patients
Kenosha Community Health Center, Inc. Clinical Current Accepting new patients
Liz Hanson Will, LLC Clinical Past Accepting new patients
Kenosha Community Health Center, Inc Past Accepting new patients

Locations

2400 Belvidere Rd
Waukegan, IL 60085
Phone (847) 377-8400

3010 Grand Ave
Waukegan, IL 60085
Phone (847) 377-8296

4006 Washington Rd
Kenosha, WI 53144
Phone (262) 652-4006

4536 22nd Ave
Kenosha, WI 53140
Phone (262) 656-0044

903 S 2nd St
Silver Lake, WI 53170
Phone (262) 656-0044

Organizations & group practices 9

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": "1506902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782950400000",
    "number": "1962912287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4006 WASHINGTON RD",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531444819",
            "telephone_number": "262-656-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4006 WASHINGTON RD",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531444819",
            "telephone_number": "262-656-0044"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "903 S 2nd St",
            "address_purpose": "LOCATION",
            "city": "Silver Lake",
            "state": "WI",
            "postal_code": "531701747",
            "country_code": "US",
            "telephone_number": "262-771-3558",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "930 Dr Martin Luther King Dr",
            "address_purpose": "LOCATION",
            "city": "Racine",
            "state": "WI",
            "postal_code": "534043008",
            "country_code": "US",
            "telephone_number": "262-771-3558",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4536 22nd Ave",
            "address_purpose": "LOCATION",
            "city": "Kenosha",
            "state": "WI",
            "postal_code": "531405917",
            "country_code": "US",
            "telephone_number": "262-656-0044",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6226 14th Ave",
            "address_purpose": "LOCATION",
            "city": "Kenosha",
            "state": "WI",
            "postal_code": "531434413",
            "country_code": "US",
            "telephone_number": "262-656-0044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROCHA",
        "first_name": "JOHN",
        "middle_name": "LEWIS",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-02",
        "last_updated": "2026-07-02",
        "certification_date": "2026-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "11992-123",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.019738",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100285135",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

Verify at the official NPI Registry.