Active NPI
Stephen Michael O'Shaughnessy
- Marriage & Family Therapist
- Fort Wayne, IN
National Provider Identifier
1679870646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 85000019A
- Practice address
- 3407 Rolston St
Fort Wayne, IN 46805-1535 - Phone
- (260) 609-3360
- NPI assigned
- Feb 27, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 85000019A | IN | Primary |
Addresses
Primary practice location
3407 Rolston St
Fort Wayne, IN 46805-1535
Mailing address
3407 Rolston St
Fort Wayne, IN 46805-1535
Phone (260) 609-3360
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 85000019A | IN | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1298764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1298764800000",
"number": "1679870646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3407 ROLSTON ST",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468051535",
"telephone_number": "260-609-3360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3407 ROLSTON ST",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468051535",
"telephone_number": "260-609-3360"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'SHAUGHNESSY",
"first_name": "STEPHEN",
"middle_name": "MICHAEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-02-27",
"last_updated": "2011-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "IN",
"license": "85000019A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.