Individual
MR. CAMERON LEE SHACKELFORD II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
2013 S ANTHONY BLVD, FORT WAYNE, IN 46803-3609
(260) 255-3514
Mailing address
2410 VANCE AVE, FORT WAYNE, IN 46805-2318
(260) 203-6380
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
33013488A
IN
Other
Enumeration date
01/14/2026
Last updated
01/14/2026
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