SAMANTHA LEE THEBEAULT (NPI# 1336504836) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336504836 |
| Entity Type | Individual |
| Full Name | SAMANTHA LEE THEBEAULT |
| Credential | M.S., CF-SLP |
| Practice Address |
888 N Main St Brockton MA 02301-1668 |
| Practice Telephone | 5085876556 |
| Mailing Telephone | 5085876556 |
| Enumeration Date | 2015-12-28 |
| Last Update Date | 2015-12-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
888 N MAIN ST |
| City | BROCKTON |
| State | MA |
| Zip Code | 02301-1668 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568671501 | Priyanka Wadhwa | Occupational Therapist | 888 N Main St, Brockton, MA 02301-1668 | 2007-05-22 |
| 1326536483 | Erin Elisabeth Mullen | Occupational Therapist | 888 N Main St, Brockton, MA 02301-1668 | 2018-04-24 |
| 1831643246 | Rachel Finer | Specialist | 888 N Main St, Brockton, MA 02301-1668 | 2016-08-15 |
| 1588034383 | Wade Roach | Occupational Therapy Assistant | 888 N Main St, 5085876566, Brockton, MA 02301-1668 | 2015-10-06 |
| 1336537687 | Jessica Marie Pickett | Occupational Therapist | 888 N Main St, Brockton, MA 02301-1668 | 2015-01-08 |
| 1689071631 | Cynthia Reidmorrison | Physical Therapy Assistant | 888 N Main St, Brockton, MA 02301-1668 | 2014-11-19 |
| 1043622236 | Elisabeth Gardner | Occupational Therapist | 888 N Main St, Brockton, MA 02301-1668 | 2014-05-22 |
| 1376963090 | Francine Kier Decasa Quianzon | Physical Therapist | 888 N Main St, Brockton, MA 02301-1668 | 2014-04-21 |
| 1154618981 | Ellen Morris-manchester | Speech-Language Pathologist | 888 N Main St, Brockton, MA 02301-1668 | 2011-06-30 |
| 1568616464 | Colleen Marie Doherty | Physical Therapist | 888 N Main St, Brockton, MA 02301-1668 | 2008-11-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942807110 | Jenny Vulpis | Recreation Therapist | 940 Belmont St (br 135), Brockton, MA 02301 | 2020-10-01 |
| 1205444924 | Caroline Storey | Counselor | Men's Addiction Treatment Center, 10 Meadowbrook Road, Brockton, MA 02301 | 2020-07-20 |
| 1013546852 | Nuria Dos Santos Veiga | Occupational Therapist | 73 Denton St, Brockton, MA 02301 | 2020-04-03 |
| 1679113930 | Laura Ann Brondyk II | Counselor | 10 Christys Dr, Brockton, MA 02301 | 2020-01-14 |
| 1437796521 | Andrea Lopes | Developmental Therapist | 7 Goddard Road, Brockton, MA 02301 | 2019-12-08 |
| 1518420124 | Diligencehealthcare | Psychiatry & Neurology | 30-40 Westpark Street, Brockton, MA 02301 | 2019-04-10 |
| 1124530373 | Rachel Theys | Behavioral Analyst | 130 Liberty St Ste 13a, Brockton, MA 02301 | 2017-10-27 |
| 1689193369 | Anderson D Delgado | Behavior Technician | 11 Packard Way, Brockton, MA 02301 | 2017-09-14 |
| 1811415326 | Francesca Lavecchia | Clinical Neuropsychologist | Brockto Area Multi Service, Inc. 10 Christy Dr., Brockton, MA 02301 | 2017-09-05 |
| 1831615343 | Donna Marie Dugan | Counselor | South Bay Community Services, 340 Main Street - Suite 818, Worcester, MA 02301 | 2017-08-16 |
| Find all providers in zip 02301 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992305338 | Rebecca Rivas | Student in an Organized Health Care Education/Training Program | 419 Court St, Brockton, MA 02302-2809 | 2020-10-26 |
| 1053920256 | Scott Pratt | Student in an Organized Health Care Education/Training Program | 35 Hancock Ave, Brockton, MA 02301-2939 | 2020-07-24 |
| 1437773629 | Samuel Dean | Student in an Organized Health Care Education/Training Program | 425 Pleasant St Ste 1, Brockton, MA 02301-2533 | 2020-06-03 |
| 1073148540 | Jennifer Thim Oung | Student in an Organized Health Care Education/Training Program | 55 Michael Dr, Brockton, MA 02301-6219 | 2020-03-05 |
| 1013566629 | Despina Arabatzis | Student in an Organized Health Care Education/Training Program | 74 Frankton Ave, Brockton, MA 02301-1554 | 2019-09-06 |
| 1114417797 | Katherine Douglas Van Schaik | Student in an Organized Health Care Education/Training Program | Brockton Signature Healthcare-bidmc, 680 Centre Street, Brockton, MA 02302 | 2018-05-18 |
| 1700376365 | Emmanuel Carrodeguas | Student in an Organized Health Care Education/Training Program | Brockton Hospital, 680 Centre Street, Brockton, MA 02302 | 2018-05-18 |
| 1205364395 | Amy P Coole | Student in an Organized Health Care Education/Training Program | 103 Commercial St Fl 2, Brockton, MA 02302-3101 | 2017-06-01 |
| 1861930653 | Chelsea Paige Dunstan | Student in an Organized Health Care Education/Training Program | 891 Montello St, Brockton, MA 02301 | 2017-02-01 |
| 1649640418 | Shanice Pullen | Student in an Organized Health Care Education/Training Program | 41 Linnea Ave, Brockton, MA 02301-6425 | 2015-10-05 |
| Find all providers in BROCKTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.