Individual provider Active NPI

Megan Shae-Robinson Pena, MA

  • Psychologist
  • Nunica, MI
National Provider Identifier
1114170800
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6361006314 Issued in MI
Practice address
17160 130TH Ave
Nunica, MI 49448-9450
Phone
(616) 301-8000
NPI assigned
Oct 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6301013842 MI
Psychologist 103T00000X 6361006314 MI Primary

Addresses

Primary practice location

17160 130TH Ave
Nunica, MI 49448-9450

Mailing address

17160 130TH Ave
Nunica, MI 49448-9450
Phone (616) 301-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

NPI Registry JSON

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755129600000",
    "number": "1114170800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17160 130TH AVE",
            "city": "NUNICA",
            "state": "MI",
            "postal_code": "494489450",
            "telephone_number": "616-301-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17160 130TH AVE",
            "city": "NUNICA",
            "state": "MI",
            "postal_code": "494489450",
            "telephone_number": "616-301-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA",
        "first_name": "MEGAN",
        "middle_name": "SHAE-ROBINSON",
        "name_prefix": "Ms.",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-28",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301013842",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6361006314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nunica, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.