Individual provider Active NPI

Shannon Lee Costa, MS, LMHC

  • Mental Health Counselor
  • Bedford, MA
National Provider Identifier
1073169918
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
11076 Issued in MA
Practice address
205 Burlington Rd
Bedford, MA 01730-1406
Phone
(781) 761-5155
NPI assigned
Aug 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 11076 MA Primary

Addresses

Primary practice location

205 Burlington Rd
Bedford, MA 01730-1406

Mailing address

205 Burlington Rd
Bedford, MA 01730-1406
Phone (781) 761-5155

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20240116000428 MA Practitioner - Mental Health Counselor 0042662041 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Child and Family Psychological Services PLLCGroup PAC ID 5991763823, 260 clinicians

Practice addresses (Care Compare)

25 Birch St
Milford, MA 01757-3585
Phone (781) 551-0999

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Child and Family Psychological Services, PLLC Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

1003 S Main St
Bellingham, MA 02019
Phone (508) 883-0600

25 Birch St
Ste A
Milford, MA 01757
Phone (508) 395-6970

89 Access Rd
Ste 24
Norwood, MA 02062
Phone (781) 336-5040

169 Libbey Park
Weymouth, MA 02189
Phone (508) 238-7766

Organizations & group practices 1

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": "1565827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1073169918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 BURLINGTON RD",
            "city": "BEDFORD",
            "state": "MA",
            "postal_code": "017301406",
            "telephone_number": "781-761-5155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 BURLINGTON RD",
            "city": "BEDFORD",
            "state": "MA",
            "postal_code": "017301406",
            "telephone_number": "781-761-5155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTA",
        "first_name": "SHANNON",
        "middle_name": "LEE",
        "credential": "MS, LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-15",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "11076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, MA

Sources for this page

Verify at the official NPI Registry.