Shannon M Harbin PHD LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

SHANNON M HARBIN PHD LLC

Practice address

36216 Freedom Rd Ste 27
Farmington Hills, MI 48335-3002

Phone

(734) 335-0845

NPI assigned

Aug 7, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Shannon M Harbin, PHDNPI 1972029676

Title

Licensed Clinical Psychologist

Phone

(734) 335-0845

Specialties & licenses 2

Addresses

Other names 1

• Mindful Development, PLLC Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shannon Marie Harbin, PHD LP

  • Clinical Psychologist
  • Farmington Hills, MI
  • NPI 1972029676
  Medicare reassignment NPD Authorized official
• Robert I Boorstein, DO

  • Surgery Physician
  • Farmington Hills, MI
  • NPI 1518059997
  NPD (past)

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

{
    "created_epoch": "1691366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696377600000",
    "number": "1013699206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36216 FREEDOM RD STE 27",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483353002",
            "telephone_number": "734-335-0845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36216 FREEDOM RD STE 27",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483353002",
            "telephone_number": "734-335-0845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANNON M HARBIN PHD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-07",
        "last_updated": "2023-10-04",
        "certification_date": "2023-09-26",
        "status": "A",
        "authorized_official_last_name": "HARBIN",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "LICENSED CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "734-335-0845",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mindful Development, PLLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mindful Development, PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cole Shand
• Irina Omarievna Shanidze, M.D.
• Kendall Shankland
• Tamar Shanks
• Curtis Lamont Shannon Jr
• Shannon Sugarman Psychotherapy
• Latasha Shannon
• Rachel N Shannon
• Serenity Shannon
• Paul Shanor

• Adult Mental Health Clinic/Center in Farmington Hills, MI
• Providers in Farmington Hills, MI by specialty
• Adult Mental Health Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.