Individual provider Active NPI

Shannan Gros

  • Mental Health Counselor
  • Thibodaux, LA
National Provider Identifier
1841052560
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
201 W 7TH St Ste 7
Thibodaux, LA 70301-3242
Phone
(985) 228-6223
Fax
(985) 228-6230
NPI assigned
Jan 29, 2024
Last updated
Jan 29, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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 LA Primary

Addresses

Primary practice location

201 W 7TH St Ste 7
Thibodaux, LA 70301-3242

Mailing address

213 Saint Mary St Ste 218
Thibodaux, LA 70301-2634
Phone (985) 228-6223

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bayou Healthcare Services, LLC CurrentSince Feb 4, 2024 Accepting new patients

Locations

201 W 7th St
Ste 7
Thibodaux, LA 70301
Phone (985) 228-6223

213 Saint Mary St
Ste 218
Thibodaux, LA 70301

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1706486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1841052560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 SAINT MARY ST STE 218",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703012634",
            "telephone_number": "985-228-6223",
            "fax_number": "985-228-6230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 W 7TH ST STE 7",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703013242",
            "telephone_number": "985-228-6223",
            "fax_number": "985-228-6230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROS",
        "first_name": "SHANNAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-29",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thibodaux, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.