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1710463633 NPI number — ROBIN SUZANNE MCCOY SHANKIN LPC

NPI Number: 1710463633
Health Care Provider/Practitioner: ROBIN SUZANNE MCCOY SHANKIN LPC

Information about “1710463633” NPI (ROBIN SUZANNE MCCOY SHANKIN LPC) exists in 1710463633 in HTML format HTML  |  1710463633 in plain Text format TXT  |  1710463633 in PDF (Portable Document Format) PDF  |  1710463633 in an XML format XML  formats.

NPI Number : 1710463633 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1710463633",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SHANKIN",
    "FirstName": "ROBIN",
    "MiddleName": "SUZANNE MCCOY",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "LPC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "MCCOY",
    "OtherFirstName": "ROBIN",
    "OtherMiddleName": "SUZANNE",
    "OtherNamePrefix": "MS.",
    "OtherNameSuffix": null,
    "OtherCredential": "LPC",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "5254 KNOLL PLACE DR SE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "GRAND RAPIDS",
    "MailingAddressStateName": "MI",
    "MailingAddressPostalCode": "49546-7518",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "586-817-0417",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "300 68TH ST SE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "GRAND RAPIDS",
    "PracticeLocationAddressStateName": "MI",
    "PracticeLocationAddressPostalCode": "49548-6927",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "616-455-5000",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "07/13/2018",
    "LastUpdateDate": "06/19/2023",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "103T00000X",
          "TaxonomyName": "Psychologist",
          "LicenseNumber": "6352000836",
          "LicenseNumberStateCode": "MI",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "101Y00000X",
          "TaxonomyName": "Counselor",
          "LicenseNumber": "6401015266",
          "LicenseNumberStateCode": "MI",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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