Provider Demographics
NPI:1225468101
Name:SHANKIN, SHAWYN'QUE WHITNEY (LMFT)
Entity Type:Individual
Prefix:
First Name:SHAWYN'QUE
Middle Name:WHITNEY
Last Name:SHANKIN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29734 CITATION CIR APT 24205
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331-5831
Mailing Address - Country:US
Mailing Address - Phone:734-629-2004
Mailing Address - Fax:
Practice Address - Street 1:26555 EVERGREEN RD STE 870
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-4239
Practice Address - Country:US
Practice Address - Phone:248-430-0594
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-14
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4101007157106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist