Ms Carly Blake Shannon, LPC in Austin, TX - Medicare Counselor Provider

Ms Carly Blake Shannon, LPC is a medicare enrolled "Counselor - Professional" provider in Austin, Texas. Her current practice location is 1433 Fairfield Dr, Austin, Texas. You can reach out to her office (for appointments etc.) via phone at (512) 491-8444.

Ms Carly Blake Shannon is licensed to practice in Texas (license number 62456) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1407001258.

Contact Information

	Ms Carly Blake Shannon, LPC
	1433 Fairfield Dr, Austin, TX 78758-7244
	(512) 491-8444
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Ms Carly Blake Shannon
Gender	Female
Speciality	Counselor - Professional
Location	1433 Fairfield Dr, Austin, Texas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1407001258
Provider Enumeration Date: 11/20/2008
Last Update Date: 11/20/2008

Medicare PECOS Information:

PECOS PAC ID: 7517307267
Enrollment ID: I20240429003402

Medical Identifiers

Medical identifiers for Ms Carly Blake Shannon such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1407001258	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YP2500X	Counselor - Professional	62456 (Texas)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ms Carly Blake Shannon allows following entities to bill medicare on her behalf.

Entity Name	Deep Eddy Psychotherapy Management, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1457740862 PECOS PAC ID: 2264886936 Enrollment ID: O20230928002745

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Carly Blake Shannon is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Ms Carly Blake Shannon, LPC 1433 Fairfield Dr, Austin, TX 78758-7244 Ph: (512) 491-8444	Ms Carly Blake Shannon, LPC 1433 Fairfield Dr, Austin, TX 78758-7244 Ph: (512) 491-8444

Reviews and Comments

Counselor in Austin, TX

Mr. David A Miller, LPC, MED Counselor Medicare: Not Enrolled in Medicare Practice Location: 1001 West Ave Ste B, Austin, TX 78701 Phone: 512-608-2024
Ms. Virginia Adams Bloom, MED, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1310 S 1st St Ste 200, Austin, TX 78704 Phone: 512-627-0390 Fax: 512-288-1909
Trina K Bluford Ita, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 910 E Cesar Chavez St, Austin, TX 78702 Phone: 888-823-9194 Fax: 888-708-9413
Laura Violeta Duenas-guerrero, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2525 Wallingwood Dr, Bldg. 8, Ste. 800, Austin, TX 78746 Phone: 512-348-8713
Paula Nicholas Storrer, MA, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2404 W 8th St, Austin, TX 78703 Phone: 512-925-2412
Amanda Lorina Cartwright, LCSW, LCDC Counselor Medicare: Accepting Medicare Assignments Practice Location: 4005 Spicewood Springs Rd Ste B401, Austin, TX 78759 Phone: 512-807-0898
Jessica Lynn Stewart, M.A., LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 5015 S Ih 35, Austin, TX 78744 Phone: 512-804-3202

Ms Carly Blake Shannon, LPC - Medicare Counselor in Austin, TX