Active NPI
Robin Suzanne McCoy Shankin, LPC
- Psychologist
- Grand Rapids, MI
National Provider Identifier
1710463633
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6352000836
- Practice address
- 300 68TH St SE
Grand Rapids, MI 49548-6927 - Phone
- (616) 455-5000
- NPI assigned
- Jul 13, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6352000836 | MI | Primary |
| Counselor | 101Y00000X | 6401015266 | MI |
Addresses
Primary practice location
300 68TH St SE
Grand Rapids, MI 49548-6927
Mailing address
5254 Knoll Place Dr SE
Grand Rapids, MI 49546-7518
Phone (586) 817-0417
Other practice location 1
28303 Dequindre Rd
Madison Heights, MI 48071-3040
Phone (419) 963-3682
Other names 1
- Ms. Robin Suzanne McCoy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6401015266 | MI | MD | Counselor |
| 6352000836 | MI | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687132800000",
"number": "1710463633",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5254 KNOLL PLACE DR SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495467518",
"telephone_number": "586-817-0417"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 68TH ST SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495486927",
"telephone_number": "616-455-5000"
}
],
"practiceLocations": [
{
"address_1": "28303 Dequindre Rd",
"address_purpose": "LOCATION",
"city": "Madison Heights",
"state": "MI",
"postal_code": "480713040",
"country_code": "US",
"telephone_number": "419-963-3682",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHANKIN",
"first_name": "ROBIN",
"middle_name": "SUZANNE MCCOY",
"name_prefix": "Mrs.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-13",
"last_updated": "2023-06-19",
"certification_date": "2023-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6352000836",
"primary": true
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MI",
"license": "6401015266",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ROBIN",
"last_name": "MCCOY",
"middle_name": "SUZANNE",
"prefix": "MS.",
"credential": "LPC",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.