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

Shannon Thebado

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1821801135

Shannon Thebado is a Nurse Practitioner in Brockton, Massachusetts. Qualified in 2024, 2 years ago. Practices with Northeast Health Services LLC, a 469-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Massachusetts.

Years since qualifying
2
Licensed in
MA
In the registry since
2025
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Practice location Address checks out

231 Main St Fl 3
Brockton, MA 02301-4342
Phone: (508) 586-2660
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence RN2330456 (MA)

Record details

NPI number1821801135
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJanuary 30, 2025
Last updated in NPPESJanuary 30, 2025
Certification dateJanuary 30, 2025
Mailing address315 Canton St, Stoughton, MA 02072-2205

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Northeast Health Services Llc — 469 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Brockton