1. Home
  2. Directory
  3. Wisconsin
  4. Glendale
  5. Social Worker
  6. NPI Profile

SHANE LEACH LCSW
NPI 1861332827
Social Worker - Clinical in Glendale, WI

Active since March 30, 2026PECOS Enrolled
5555 N PORT WASHINGTON RD STE 200, GLENDALE, WI 53217(262) 999-3495(262) 821-6180 Get Directions Write a Review

NPPES record last updated: May 5, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 5, 2026, Mar 30, 2026 (2 updates tracked since 2026).

About Shane Leach Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHANE LEACH LCSW (NPI 1861332827) is an individual clinical provider in Glendale, Wisconsin, licensed in Wisconsin (12713-123) and active in the NPI registry since March 2026. He is enrolled in Medicare PECOS and maintains a secondary practice location in Glendale.

NPPES Registry Identity

NPI1861332827
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameSHANE LEACHCredential: LCSW
Location Address5555 N PORT WASHINGTON RD STE 200Glendale, WI 53217-4927
Mailing Address5555 N Port Washington Rd Ste 200Glendale, WI 53217-4927 · (262) 999-3495 · Fax (262) 821-6180
Phone(262) 999-3495
Fax(262) 821-6180
Sole ProprietorNo
Enumeration DateMarch 30, 2026
Last NPPES UpdateMay 5, 20262 updates tracked since enumeration
NPPES CertifiedMay 5, 2026
✔ NPI 1861332827 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in WI · 12713-123
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
5555 N PORT WASHINGTON RD STE 200, Glendale, WI 53217
Open in Google Maps ↗

Secondary Practice Location 1

Location 15650 N Green Bay Ave Ste 205Glendale, WI 53209-4446 · Phone (855) 914-2881 · Fax (414) 921-5652

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shane Leach Lcsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53217 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $53.90 – $163.24
Typical copayment $0.00 (range $13.47 – $40.81)
Most-billed visit code NA
Established Patient
$67.37 typical visit price
range $17.40 – $133.76
Typical copayment $16.84 (range $4.35 – $33.44)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JEFFREY M NERONE
Counselor (Professional)
5555 N PORT WASHINGTON RD STE 200
GLENDALE, WI 53217
Milwaukee County (262) 789-1191
SUSAN E COHEN LCSW
Social Worker (Clinical)
5555 N PORT WASHINGTON RD STE 200
GLENDALE, WI 53217
Milwaukee County (262) 999-3495
DAVID C POEHLMANN CSAC, LCSW, ICS
Social Worker (Clinical)
5555 N PORT WASHINGTON RD STE 200
GLENDALE, WI 53217
Milwaukee County (262) 999-3495
MS. MARIE-THERESE HELLRUNG MS, LMFT
Marriage & Family Therapist
5555 N PORT WASHINGTON RD STE 200, SUITE 100
GLENDALE, WI 53217
Milwaukee County (262) 789-1191
BRADLEY KYLE BROWN LPC
Counselor (Professional)
5555 N PORT WASHINGTON RD STE 200
GLENDALE, WI 53217
Milwaukee County (262) 999-3495
NAKITA DOMINIQUE CLEVELAND HICKLES LPC
Counselor (Professional)
5555 N PORT WASHINGTON RD STE 200
GLENDALE, WI 53217
Milwaukee County (262) 999-3495
MS. KARI LYNN DI FONZO LCSW,
Social Worker (Clinical)
5555 N PORT WASHINGTON RD STE 200
GLENDALE, WI 53217
Milwaukee County (262) 999-3495
CHRISTOPHER WOJNAR PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
5555 N PORT WASHINGTON RD STE 200
GLENDALE, WI 53217
Milwaukee County (262) 999-3495

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shane Leach's NPI number?

The NPI number for Shane Leach is 1861332827. It was assigned to this individual provider in the NPPES registry on March 30, 2026.

Where is Shane Leach located?

Shane Leach practices at 5555 N Port Washington Rd Ste 200, Glendale, WI 53217. The listed phone number is (262) 999-3495.

What is Shane Leach's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Shane Leach enrolled in Medicare?

Yes. Shane Leach is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Shane Leach was last updated on May 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.