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SHANNON LEE DERBY LMHC, CAC
NPI 1962365940
Counselor - Mental Health in Marlborough, MA

Active since December 05, 2025PECOS Enrolled
28 LORD RD STE 215, MARLBOROUGH, MA 01752(781) 666-2711 Get Directions Write a Review

NPPES record last updated: July 1, 2026. Verified against the NPPES registry weekly; last sync: September 06, 2026.

About Shannon Lee Derby Lmhc, Cac NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHANNON LEE DERBY LMHC, CAC (NPI 1962365940) is an individual mental health provider in Marlborough, Massachusetts, licensed in Florida (MH17175) and active in the NPI registry since December 2025. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1962365940
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameSHANNON LEE DERBYCredential: LMHC, CAC
Location Address28 LORD RD STE 215Marlborough, MA 01752-4549
Mailing Address28 Lord Rd Ste 215Marlborough, MA 01752-4549 · (781) 666-2711
Phone(781) 666-2711
Sole ProprietorYes
Enumeration DateDecember 5, 2025
Last NPPES UpdateJuly 1, 2026
NPPES CertifiedJuly 1, 2026
✔ NPI 1962365940 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in FL · MH17175
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License CAC.100099 (FL)
28 LORD RD STE 215, Marlborough, MA 01752
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shannon Lee Derby Lmhc, Cac is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DANA MICHELLE GONZALEZ MSW
Social Worker (Clinical)
28 LORD RD STE 215
MARLBOROUGH, MA 01752
Middlesex County (781) 666-2711
BIANKAH KISER-MIRANDA
Counselor (Mental Health)
28 LORD RD STE 215
MARLBOROUGH, MA 01752
Middlesex County (781) 666-2711
GRACE DIAMOND NP
Nurse Practitioner (Psychiatric/Mental Health)
28 LORD RD STE 215
MARLBOROUGH, MA 01752
Middlesex County (781) 666-2711
PARAMITA PAL ROY PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
28 LORD RD STE 215
MARLBOROUGH, MA 01752
Middlesex County (781) 666-2711
JOSE NIEVES LCSW
Social Worker (Clinical)
28 LORD RD STE 215
MARLBOROUGH, MA 01752
Middlesex County (781) 666-2711
CHRISTINA NOEL BURKE LICSW
Social Worker (Clinical)
28 LORD RD STE 215
MARLBOROUGH, MA 01752
Middlesex County (781) 666-2711
AMBER CAITLYN BENTLEY PA
Physician Assistant
28 LORD RD STE 215
MARLBOROUGH, MA 01752
Middlesex County (781) 666-2711

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shannon Derby's NPI number?

The NPI number for Shannon Derby is 1962365940. It was assigned to this individual provider in the NPPES registry on December 5, 2025.

Where is Shannon Derby located?

Shannon Derby practices at 28 Lord Rd Ste 215, Marlborough, MA 01752. The listed phone number is (781) 666-2711.

What is Shannon Derby's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Shannon Derby enrolled in Medicare?

Yes. Shannon Derby is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Shannon Derby was last updated on July 1, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.