Shannon Walters-Harvey

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

1010 E Dupont Rd
Fort Wayne, IN 46825-1554

Phone

(260) 471-8141

NPI assigned

Feb 20, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bowen Health Inc

  • Adult Mental Health Clinic/Center
  • Warsaw, IN
  • NPI 1639172810
  Medicare reassignment NPD
• Mindful Emotions Counseling, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fort Wayne, IN
  • NPI 1659155943
  NPD Authorized official
• Bowen Health Inc

  • Federally Qualified Health Center (FQHC)
  • Fort Wayne, IN
  • NPI 1023668183
  NPD
• Center for Neurobehavioral Services Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fort Wayne, IN
  • NPI 1548275258
  NPD (past)
• Cook Behavioral Health Clinic, PC

  • Psychologist
  • Fort Wayne, IN
  • NPI 1265691257
  NPD (past)

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

{
    "created_epoch": "1329696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686009600000",
    "number": "1649543729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13222 TREMONT CT",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468140007",
            "telephone_number": "260-445-0791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 E DUPONT RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251554",
            "telephone_number": "260-471-8141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS-HARVEY",
        "first_name": "SHANNON",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-20",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Susan Wallace
• Joshua Michael Wallet, M.D.
• Katherine Anne Walsh, AGNP-BC
• Susan Anne Walstra, M.D.
• Nicole Ann Walter, PT
• Brynnlee Malone Walters
• Derricia Walters
• Destinee Walters, RBT
• Joann Walters
• Nicole Elaine Walters

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.