SHELLY J EDWARDS (NPI# 1902802887) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902802887 |
| Entity Type | Individual |
| Full Name | SHELLY J EDWARDS |
| Credential | LMFT |
| Practice Address |
2100 Goshen Rd Fort Wayne IN 46808-1493 |
| Practice Telephone | 2604713500 |
| Practice Fax Number | 2604714263 |
| Mailing Telephone | 2604713500 |
| Mailing Fax Number | 2604714263 |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | 35001533A | IN | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194346643 | Shelly Marie Edwards | Homemaker | 7800 Wilkinson Blvd, Charlotte, NC 28214-9148 | 2020-05-06 |
| 1104082569 | Shelly Lynn Edwards | Social Worker | 1333 Wrens Nest Way, Northport, AL 35476-4177 | 2008-08-04 |
| 1245671122 | Shelly Ann Edwards | Nurse Practitioner | 920 N Quincy Ave, Ottumwa, IA 52501-3866 | 2013-07-08 |
| 1821051327 | Shelly L Edwards | Psychologist | 14115 James Rd Ste 305, Rogers, MN 55374-9417 | 2006-04-07 |
| Street Address |
2100 GOSHEN RD |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46808-1493 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144820192 | Nicholas Ray Brauchler | Counselor | 2100 Goshen Rd, Fort Wayne, IN 46808-1493 | 2020-10-29 |
| 1063019610 | Markita R Powell | Counselor | 2100 Goshen Rd, Fort Wayne, IN 46808-1493 | 2020-10-07 |
| 1922611458 | Chase Aaron Young | Social Worker | 2100 Goshen Rd, Fort Wayne, IN 46808-1493 | 2020-08-25 |
| 1962015404 | Zachary Brock | Counselor | 2100 Goshen Rd, Fort Wayne, IN 46808-1493 | 2020-08-25 |
| 1356954887 | Ayomikun Ajani | Counselor | 2100 Goshen Rd, Fort Wayne, IN 46808-1493 | 2020-08-25 |
| 1407467210 | Allyson Thammachack | Counselor | 2100 Goshen Rd, Fort Wayne, IN 46808-1493 | 2020-08-14 |
| 1245841485 | Emily Meller | Social Worker | 2100 Goshen Rd, Fort Wayne, IN 46808-1493 | 2020-08-12 |
| 1598383457 | Jessica Mann | Counselor | 2100 Goshen Rd, Fort Wayne, IN 46808-1493 | 2020-07-08 |
| 1669097762 | Zabrina Przybilla | Counselor | 2100 Goshen Rd, Fort Wayne, IN 46808-1493 | 2020-06-15 |
| 1265057368 | Debra Clevenger | Counselor | 2100 Goshen Rd, Fort Wayne, IN 46808-1493 | 2020-06-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295347102 | Austin Hartzog | Pharmacist | 5110 Value Drive, Fort Wayne, IN 46808 | 2020-08-21 |
| 1407358377 | Bryan Black | Specialist/Technologist | 3946 Ice Way Fort Wayne, Fort Wayne, IN 46808 | 2018-03-06 |
| 1326557877 | Kimberly K Kolb | Occupational Therapy Assistant | 1431 Runnion Ave, Fort Wayne, IN 46808 | 2017-09-28 |
| 1396142063 | Christina Ryder | Specialist/Technologist | 3946 Iceway, Fort Wayne, IN 46808 | 2014-11-25 |
| 1912090440 | Neighborcare of Indiana, LLC | Pharmacy | 3402 Congressional Pkwy, Ft. Wayne, IN 46808 | 2006-10-02 |
| 1619945888 | Beth Ann Herrell | Specialist/Technologist | 3946 Ice Way, Fort Wayne, IN 46808 | 2006-03-14 |
| 1568458990 | Carolyn Warner Greer | Obstetrics & Gynecology | 1415 Directors Row, Fort Wayne, IN 46808 | 2005-09-21 |
| 1750851168 | Tyler Cheney | Specialist/Technologist | 3946 Ice Way, Fort Wayne, IN 46808 | 2018-11-28 |
| 1487123550 | Michaela Mcguire | Specialist/Technologist | 3946 Ice Way, Fort Wayne, IN 46808 | 2018-11-19 |
| 1861961088 | Olivia Marquardt | Specialist/Technologist | 3946 Ice Way, Fort Wayne, IN 46808 | 2018-11-16 |
| Find all providers in zip 46808 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487287371 | Fort Wayne Counseling Services | Marriage & Family Therapist | 6319 Mutual Dr Ste F, Fort Wayne, IN 46825-4246 | 2020-02-19 |
| 1942701214 | Joshawa Todd Torres | Marriage & Family Therapist | 5651 Coventry Ln # 116, Fort Wayne, IN 46804 | 2018-02-22 |
| 1922497775 | Mary Lisa Barta LLC | Marriage & Family Therapist | 5630 The Prophets Pass, Fort Wayne, IN 46845-9473 | 2015-01-16 |
| 1548506728 | Carmella Nicole Oneal | Marriage & Family Therapist | 4630 W Jefferson Blvd Ste 3, Fort Wayne, IN 46804-6800 | 2012-12-17 |
| 1962754523 | Matt Ryan Givens | Marriage & Family Therapist | 237 Airport North Office Park, Fort Wayne, IN 46825-6702 | 2012-10-08 |
| 1083988547 | Glenis A Sundberg | Marriage & Family Therapist | 1818 Carew St Ste 320, Fort Wayne, IN 46805-4764 | 2012-03-01 |
| 1982982898 | Ferraro Behavior Services, LLC | Marriage & Family Therapist | 9512 Lima Rd Ste 103, Fort Wayne, IN 46818-9806 | 2011-07-26 |
| 1679870646 | Stephen Michael O'shaughnessy | Marriage & Family Therapist | 3407 Rolston St, Fort Wayne, IN 46805-1535 | 2011-02-27 |
| 1760711808 | Marjorie L Havens | Marriage & Family Therapist | 2330 Beacon St, Suite 105, Fort Wayne, IN 46805-3852 | 2009-12-21 |
| 1366673956 | Melissa Ann Borton | Marriage & Family Therapist | 126 W Columbia St, Ste 300, Fort Wayne, IN 46802-1719 | 2009-07-31 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46808 |
Please comment or provide details below to improve the information on SHELLY J EDWARDS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.