Individual provider Active NPI

Shawynque Whitney Shankin, LMFT

  • Marriage & Family Therapist
  • Southfield, MI
National Provider Identifier
1225468101
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
4101007157 Issued in MI
Practice address
26555 Evergreen Rd Ste 870
Southfield, MI 48076-4239
Phone
(248) 430-0594
NPI assigned
Nov 14, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 4101007157 MI Primary

Addresses

Primary practice location

26555 Evergreen Rd Ste 870
Southfield, MI 48076-4239

Mailing address

8689 Scenic Bluff LN
White Lake, MI 48386-2058
Phone (734) 629-2004

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4101007157MIMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Focus Therapy Clinic Marriage & Family Therapist CurrentSince Dec 3, 2023 Accepting new patients

Locations

330 Town Center Dr
Ste 328
Dearborn, MI 48126
Phone (248) 430-0594

26555 Evergreen Rd
Ste 870
Southfield, MI 48076
Phone (248) 430-0594

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1384387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1225468101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8689 SCENIC BLUFF LN",
            "city": "WHITE LAKE",
            "state": "MI",
            "postal_code": "483862058",
            "telephone_number": "734-629-2004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26555 EVERGREEN RD STE 870",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480764239",
            "telephone_number": "248-430-0594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANKIN",
        "first_name": "SHAWYNQUE",
        "middle_name": "WHITNEY",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-14",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MI",
            "license": "4101007157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; 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.