Individual
BRIAN SHILTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LMHC, CSAYC
Contact information
Practice address
2632 SPRINGFIELD AVE, FORT WAYNE, IN 46805-1550
(260) 341-2651
Mailing address
2632 SPRINGFIELD AVE, FORT WAYNE, IN 46805-1550
(260) 341-2651
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
88000476A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
IN
Enumeration date
02/16/2022
Last updated
03/23/2026
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