Organization
RIVERSIDE TRAUMA SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELLEN SHANNON LMHC (MEMBER)
(260) 271-3889
Entity
Organization
Contact information
Practice address
127 W BERRY ST STE 311, FORT WAYNE, IN 46802-2310
(260) 376-2242
Mailing address
127 W BERRY ST STE 311, FORT WAYNE, IN 46802-2310
(260) 376-2242
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/26/2025
Last updated
01/12/2026
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