KENNETH L. SHIELDS (NPI# 1548267743) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548267743 |
| Entity Type | Individual |
| Full Name | KENNETH L. SHIELDS |
| Credential | LMHC |
| Practice Address |
11104 Parkview Circle Dr Ste 110 Fort Wayne IN 46845-1730 |
| Practice Telephone | 2604603203 |
| Practice Fax Number | 2604603130 |
| Mailing Telephone | 2604603203 |
| Mailing Fax Number | 2604603130 |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2012-12-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
87001425A | IN | Behavioral Health & Social Service Providers |
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
39001242A | IN | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134736895 | Kenneth John Shields Jr. | Behavioral Analyst | 750 Essington Rd, Joliet, IL 60435-4912 | 2020-09-28 |
| Street Address |
11104 PARKVIEW CIRCLE DR STE 110 |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46845-1730 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184621641 | Thomas J. Curfman | Psychiatry & Neurology | 11104 Parkview Circle Dr, Ste 110, Fort Wayne, IN 46845-1730 | 2005-06-30 |
| 1174124143 | Ellen Nicole Eckhart | Physical Therapist | 11104 Parkview Circle Dr, Fort Wayne, IN 46845-1672 | 2020-11-05 |
| 1912508169 | Bryson James Robuck | Registered Nurse | 11104 Parkview Circle Dr, Fort Wayne, IN 46845-1672 | 2020-11-04 |
| 1568062644 | Brandi Nicolette-baker | Occupational Therapist | 11104 Parkview Circle Dr, Suite 050, Fort Wayne, IN 46845-1733 | 2020-10-28 |
| 1649723818 | April Jeanne Jenkins | Nurse Practitioner | 11104 Parkview Circle Dr, Ste 110, Fort Wayne, IN 46845-1673 | 2016-07-25 |
| 1497111991 | Janelle Miller | Nurse Practitioner | 11104 Parkview Circle Dr, Suite 310, Fort Wayne, IN 46845-1672 | 2016-01-13 |
| 1770957680 | Kathleen O'keefe | Registered Nurse | 11104 Parkview Circle Dr, Ste. 310, Fort Wayne, IN 46845-1672 | 2015-11-17 |
| 1114302056 | Christy Ann Auld | Nurse Practitioner | 11104 Parkview Circle Dr, Suite 410, Fort Wayne, IN 46845-1672 | 2015-07-21 |
| 1790169233 | Blair Fifer | Nurse Practitioner | 11104 Parkview Circle Dr, Suite 310, Fort Wayne, IN 46845-1672 | 2015-07-15 |
| 1013318427 | Andrea Jantson Smith | Physical Therapist | 11104 Parkview Circle Dr, Fort Wayne, IN 46845 | 2014-09-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881154110 | Nancy Jean Ehmke | Clinical Nurse Specialist | 11151 Parkview Plaza Dr, Fort Wayne, IN 46845 | 2019-03-22 |
| 1043703903 | Kara Stackhouse | Nurse Practitioner | 11050 Parkview Plaza Drive, Fort Wayne, IN 46845 | 2018-06-14 |
| 1871082412 | Tara K Jellison | Pharmacist | 11109 Parkview Plaza Drive -- Attn Pharmacy, Fort Wayne, IN 46845 | 2018-05-09 |
| 1578097572 | Forefront Dermatology, S.c. | Dermatology | 4020 New Vision Drive, Fort Wayne, IN 46845 | 2017-04-17 |
| 1811437999 | Jessica Ann Lefever | Behavioral Analyst | 3898 New Vision Dr Ste D, Fort Wayne, IN 46845 | 2017-03-08 |
| 1033668041 | Bhi Home Care, Inc. | In Home Supportive Care | 820 Mill Lake Road, Fort Wayne, IN 46845 | 2016-10-03 |
| 1467814939 | Austin Wyss | Specialist/Technologist | 11130 Parkview Circle Drive, Ft. Wayne, IN 46845 | 2016-03-24 |
| 1154713584 | Ashley Whitcraft | Specialist/Technologist | 11130 Parkview Plaza Drive #4, Fort Wayne, IN 46845 | 2015-02-23 |
| 1275975682 | Lakshmi Mohan Viji Das | Internal Medicine | 11143 Parkview Plaza Dr Ste 311, Fort Wayne, IN 46845 | 2013-07-26 |
| 1336482496 | Mithun Mohana Shenoi | Colon & Rectal Surgery | 11104 Parkview Circle Drive Suite 320, Fort Wayne, IN 46845 | 2013-03-27 |
| Find all providers in zip 46845 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548881899 | Emily H Cook | Counselor | 2130 Pemberton Dr, Fort Wayne, IN 46805-4628 | 2020-04-28 |
| 1871113274 | At Your Pace Counseling, LLC | Counselor | 6717 Sky Blue Dr, Fort Wayne, IN 46804-4648 | 2020-04-26 |
| 1962049809 | Lynne Beardsley | Counselor | 4630 W Jefferson Blvd Ste 11, Fort Wayne, IN 46804-6856 | 2019-12-10 |
| 1578108767 | Wholistic Wellness Counseling and Consulting LLC | Counselor | 1129 Rivermet Ave, Fort Wayne, IN 46805-4232 | 2019-11-11 |
| 1922654722 | Nicole Conrad | Counselor | 908 Manck Dr, Fort Wayne, IN 46814-8995 | 2019-08-16 |
| 1336794148 | Healing Through Art | Counselor | 3521 Lake Ave # B1, Fort Wayne, IN 46805-5536 | 2019-08-08 |
| 1013578749 | A.w. Holdings, LLC | Counselor | 3900 Hursh Rd, Fort Wayne, IN 46845-9677 | 2019-06-24 |
| 1811450646 | Living Waters Peace Center | Counselor | 3262 Mallard Cove Ln Ste B, Fort Wayne, IN 46804-2883 | 2019-04-09 |
| 1447718325 | Victoria Lynn Prokop | Counselor | 4656 W Jefferson Blvd Ste 210, Fort Wayne, IN 46804-6884 | 2019-03-09 |
| 1811467632 | Believe Counseling and Consulting | Counselor | 2200 Lake Ave Ste 140, Fort Wayne, IN 46805-5351 | 2018-12-05 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46845 |
Please comment or provide details below to improve the information on KENNETH L. SHIELDS.
| 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.