Individual provider Active NPI

Shannon Drabek, PSY.D.

  • Clinical Psychologist
  • Byron Center, MI
National Provider Identifier
1023673688
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301018911 Issued in MI
Practice address
6500 Byron Center Ave SW
Byron Center, MI 49315-9080
Phone
(162) 816-3116
NPI assigned
May 8, 2019
Last updated
Jan 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301018911 MI Primary

Addresses

Primary practice location

6500 Byron Center Ave SW
Byron Center, MI 49315-9080

Mailing address

300 68TH St SE
Grand Rapids, MI 49548-6927

Other practice location 1

300 68th St SE
Grand Rapids, MI 49548-6927
Phone (616) 455-5000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address PineRestCMHS@directaddress.pinerest.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210817000246 MI Practitioner - Clinical Psychologist 2567867435 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

300 68TH St SE
Grand Rapids, MI 49548-6927
Phone (616) 455-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6301018911MIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pine Rest Christian Mental Health Services Multi-Specialty CurrentSince Aug 12, 2021 Accepting new patients
Pine Rest Christian Mental Health Services Psychologist CurrentSince Aug 12, 2021 Accepting new patients

Locations

6500 Byron Center Ave SW
Byron Center, MI 49315
Phone (616) 281-6311

300 68th St SE
Wyoming, MI 49548
Phone (616) 455-5000

Organizations & group practices 2

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": "1557273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1023673688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 68TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495486927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 BYRON CENTER AVE SW",
            "city": "BYRON CENTER",
            "state": "MI",
            "postal_code": "493159080",
            "telephone_number": "162-816-3116"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 68th St SE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495486927",
            "country_code": "US",
            "telephone_number": "616-455-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DRABEK",
        "first_name": "SHANNON",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-08",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301018911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "PineRestCMHS@directaddress.pinerest.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "300 68th St SE",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495486927",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Byron Center, MI

Sources for this page

Verify at the official NPI Registry.