Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Shane Leach, LCSW

Individual provider Clinical Social Worker · NPI 1861332827

Shane Leach, LCSW is a Clinical Social Worker in Glendale, Wisconsin. Qualified in 2021, 5 years ago. Works from 2 locations. Licensed in Wisconsin.

Years since qualifying
5
Licensed in
WI
In the registry since
2026
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

5555 N Port Washington Rd Ste 200
Glendale, WI 53217-4927
Phone: (262) 999-3495
Fax: (262) 821-6180
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 5650 N Green Bay Ave Ste 205, Glendale, WI 53209-4446 — (855) 914-2881

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 12713-123 (WI)

Record details

NPI number1861332827
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorNo
NPI enumeratedMarch 30, 2026
Last updated in NPPESMay 5, 2026
Certification dateMay 5, 2026
Mailing address5555 N Port Washington Rd Ste 200, Glendale, WI 53217-4927

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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