Cameron Lee Shackelford II, LSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

33013488A Issued in IN

Practice address

2013 S Anthony Blvd
Fort Wayne, IN 46803-3609

Phone

(260) 255-3514

NPI assigned

Jan 14, 2026

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1768348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768348800000",
    "number": "1477411833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 VANCE AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468052318",
            "telephone_number": "260-203-6380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2013 S ANTHONY BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468033609",
            "telephone_number": "260-255-3514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHACKELFORD",
        "first_name": "CAMERON",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-01-14",
        "last_updated": "2026-01-14",
        "certification_date": "2026-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "33013488A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Therapyappointment",
            "affiliation": "N",
            "endpointDescription": "TherapyAppointment (TA) is one of the longest-running therapy focused EMRs originally built in 2008 by a group of therapists to meet the unique needs of psychologists, psychiatrists, counselors, etc.",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Case Notes, direct email w/ clients, billing, scheduling, etc.",
            "address_1": "2013 S Anthony Blvd",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468033609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tessa Sewell, RBT
• Mark Sexton, ATC, DPT
• Melissa K Sezginer, MA, LMHC
• Eithar Elias Shabbo
• Rony Shabou, MD
• Alexis Shafer
• Chelsea Shafer, RD, LDN
• Jessica Shafer
• Kelly L. Shafer
• Tamara R Shafer, MD

• Mental Health Counselor in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Mental Health Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.