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MRS. CARLY BLAKE SHANNON LPC
NPI 1407001258
Counselor - Professional in Dallas, TX

Active since November 20, 2008PECOS EnrolledAccepts Medicare Assignment
4144 N CENTRAL EXPY STE 850, DALLAS, TX 75204(512) 956-6463(866) 653-5142 Get Directions Write a Review

NPPES record last updated: September 18, 2025. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Mrs. Carly Blake Shannon Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. CARLY BLAKE SHANNON LPC (NPI 1407001258) is an individual professional provider in Dallas, Texas, licensed in Texas (62456) and active in the NPI registry since November 2008. She is enrolled in Medicare PECOS and is a graduate of University Of North Texas Hsc, College Of Osteopathic Med (2006).

NPPES Registry Identity

NPI1407001258
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameMRS. CARLY BLAKE SHANNONCredential: LPC
Location Address4144 N CENTRAL EXPY STE 850Dallas, TX 75204-3226
Mailing Address5109 Holy Springs RdDenton, TX 76207-4237 · (512) 897-2709
Phone(512) 956-6463
Fax(866) 653-5142
Sole ProprietorNo
Medical School CMSUniversity Of North Texas Hsc, College Of Osteopathic MedGraduated 2006
Enumeration DateNovember 20, 2008
Last NPPES UpdateSeptember 18, 2025
NPPES CertifiedSeptember 18, 2025
✔ NPI 1407001258 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in TX · 62456
4144 N CENTRAL EXPY STE 850, Dallas, TX 75204
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, Oscar Insurance Company, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mrs. Carly Blake Shannon Lpc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7517307267
PECOS Enrollment IDI20240429003402
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Carly Shannon reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Deep Eddy Psychotherapy Management, LLC
184 mi
Counseling
508 DEEP EDDY AVE.
Austin, TX 78703
  • Reassigned Medicare billing, Texas enrollment
  • 108 clinicians in this Medicare group
NPI 1457740862 (512) 956-6463

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ELIZABETH BALL LPC
Counselor (Professional)
4144 N CENTRAL EXPY STE 850
DALLAS, TX 75204
Dallas County (972) 865-8782
TORI HOPE LEVINGER LPC
Counselor (Mental Health)
4144 N CENTRAL EXPY STE 850
DALLAS, TX 75204
Dallas County (512) 956-4265
BROOKE BENANDI LMFT
Marriage & Family Therapist
4144 N CENTRAL EXPY STE 850
DALLAS, TX 75204
Dallas County (972) 865-8782
SARAH ALSYE KARSNER LPC
Counselor
4144 N CENTRAL EXPY STE 850
DALLAS, TX 75204
Dallas County (972) 865-8782
ALLIE WHISTLER LPC
Counselor (Professional)
4144 N CENTRAL EXPY STE 850
DALLAS, TX 75204
Dallas County (972) 865-8762
AMBER CHRISTINE WRYE PHD, LPC-S, LCDC
Counselor (Professional)
4144 N CENTRAL EXPY STE 850
DALLAS, TX 75204
Dallas County (972) 472-2409
MRS. LARK CHERI JORDAN MA, LPC
Counselor (Mental Health)
4144 N CENTRAL EXPY STE 850
DALLAS, TX 75204
Dallas County (972) 865-8782
JEANNETTE SANCHEZ
Counselor
4144 N CENTRAL EXPY STE 850
DALLAS, TX 75204
Dallas County (972) 865-8782

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Carly Shannon's NPI number?

The NPI number for Carly Shannon is 1407001258. It was assigned to this individual provider in the NPPES registry on November 20, 2008.

Where is Carly Shannon located?

Carly Shannon practices at 4144 N Central Expy Ste 850, Dallas, TX 75204. The listed phone number is (512) 956-6463.

What is Carly Shannon's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Carly Shannon enrolled in Medicare?

Yes. Carly Shannon is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Carly Shannon's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Carly Shannon reassigns Medicare benefits to Deep Eddy Psychotherapy Management, LLC (Austin, TX). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Carly Shannon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Carly Shannon accept?

Health plans from Blue Cross and Blue Shield of Texas, Oscar Insurance Company and UnitedHealthcare list Carly Shannon as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Carly Shannon was last updated on September 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.