Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Shannon Colburn-Blinn, LCSW

Individual provider Social Worker · NPI 1053766782

Shannon Colburn-Blinn, LCSW is a Clinical Social Worker in Fort Wayne, Indiana. Qualified in 2014, 12 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
12
Licensed in
IN
In the registry since
2016
Specialties on file
2
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

2200 Lake Ave Ste 140
Fort Wayne, IN 46805-5351
Phone: (260) 471-2300
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 34007964A (IN)
Social Worker Taxonomy 104100000X · Licence 33007280A (IN)

Record details

NPI number1053766782
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorYes
NPI enumeratedMay 2, 2016
Last updated in NPPESJune 1, 2021
Certification dateJune 1, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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