Individual
ELLEN DOLORES SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSED, LMHC
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
88000982A
IN
Other
Enumeration date
03/28/2022
Last updated
02/28/2026
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