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

Susan Shively, LMT

Individual provider Massage Therapist · NPI 1871126995

Susan Shively, LMT is a Massage Therapist in Fort Wayne, Indiana. Licensed in Indiana. Registered with an NPI since 2020.

Licensed in
IN
In the registry since
2020
What do these letters mean?
LMT — Licensed Massage Therapist
A state-licensed massage therapist.

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Practice location Address checks out

4606 W Jefferson Blvd
Fort Wayne, IN 46804-6826
Phone: (260) 459-1111
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Massage Therapist (primary) Taxonomy 225700000X · Licence MT21907005 (IN)

Record details

NPI number1871126995
Entity typeIndividual (Type 1)
GenderFemale
Credentials LMT
Sole proprietorNo
NPI enumeratedFebruary 17, 2020
Last updated in NPPESFebruary 17, 2020
Certification dateFebruary 17, 2020
Mailing address4606 W Jefferson Blvd, Fort Wayne, IN 46804-6826

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