MS. CARLY BLAKE SHANNON (NPI# 1407001258) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407001258 |
| Entity Type | Individual |
| Full Name | MS. CARLY BLAKE SHANNON |
| Credential | LPC |
| Practice Address |
1433 Fairfield Dr Austin TX 78758-7244 |
| Practice Telephone | 5124918444 |
| Mailing Telephone | 5124918444 |
| Enumeration Date | 2008-11-20 |
| Last Update Date | 2008-11-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
62456 | TX | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053794842 | Carly Shannon | Occupational Therapist | 811 East Central Road, Arlington Heights, IL 60056 | 2015-06-30 |
| Street Address |
1433 FAIRFIELD DR |
| City | AUSTIN |
| State | TX |
| Zip Code | 78758-7244 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063522498 | Kearley & Schmitt Pllc | Social Worker | 1433 Fairfield Dr, Austin, TX 78758-7244 | 2006-08-30 |
| 1043744469 | Hannah Frankel | Social Worker | 1433 Fairfield Dr, Austin, TX 78758-7244 | 2017-04-12 |
| 1912387358 | Michele Henning | Counselor | 1433 Fairfield Dr, Austin, TX 78758-7244 | 2015-06-01 |
| 1841593787 | Samuel Shapiro | Psychiatry & Neurology | 1433 Fairfield Dr, Austin, TX 78758-7244 | 2010-12-15 |
| 1033356100 | Amanda Winters | Social Worker | 1433 Fairfield Dr, Austin, TX 78758-7244 | 2009-01-12 |
| 1982868311 | Luis Rene Ovalle | Social Worker | 1433 Fairfield Dr, Austin, TX 78758-7244 | 2008-07-15 |
| 1225291313 | Sandy Osborne | Counselor | 1433 Fairfield Dr, Austin, TX 78758-7244 | 2008-07-08 |
| 1003004250 | Joanne Frances Carrubba | Social Worker | 1433 Fairfield Dr, Austin, TX 78758-7244 | 2007-10-11 |
| 1871796607 | Dale Pan Hsieh | Psychiatry & Neurology | 1433 Fairfield Dr, Austin, TX 78758-7244 | 2007-06-08 |
| 1619197324 | Helen Holmes Williams | Social Worker | 1433 Fairfield Dr, Austin, TX 78758-7244 | 2007-04-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225644065 | Seton Family of Doctors | Internal Medicine | 3001 Palm Way, D1 : 134-138, Austin, TX 78758 | 2020-09-17 |
| 1083243661 | Donna Bella Laurel Portillo | Pharmacist | 12221 N Mopac Expwy, Austin, TX 78758 | 2020-04-05 |
| 1881249092 | Elizabeth Logan Anderson | Behavioral Analyst | 2100 Kramer Ln., Suite 150, Austin, TX 78758 | 2019-08-05 |
| 1295388502 | Bridget Sue Morgan | Behavioral Analyst | 2100 Kramer Ln #150, Austin, TX 78758 | 2019-07-17 |
| 1508326885 | Jonathan James Runnels | Anesthesiologist Assistant | 12221n Mopac, Austin, TX 78758 | 2019-03-22 |
| 1427527324 | Nayely Gutierrez | Dietitian, Registered | 8606 Delaware Ct, Austin, TX 78758 | 2018-11-20 |
| 1720569635 | Shari Wright | Licensed Vocational Nurse | 12349 Metric Blvs # 425, Austin, TX 78758 | 2018-08-28 |
| 1528545456 | Alexis N Bongiorno | Registered Nurse | 11901 Hobby Horse Court, 1516, Austin, TX 78758 | 2018-07-24 |
| 1679072573 | Lori Scott | Counselor | 1600 Payton Gin Road, Austin, TX 78758 | 2018-02-06 |
| 1003322488 | Lisa Robyn Lee | Behavior Technician | 2018 W Rundberg Ln, #13d, Austin, TX 78758 | 2017-12-20 |
| Find all providers in zip 78758 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457951675 | Caitlin R Battell | Counselor | 12805 Hughes St, Austin, TX 78732-1833 | 2020-10-27 |
| 1316546187 | Cathi Heare | Counselor | 1502 Ranch Road 620, Austin, TX 78734-7873 | 2020-10-22 |
| 1104425214 | Paul Lewis Duffy | Counselor | Counseling Services, 1625 Rutherford Ln., Austin, TX 78754 | 2020-10-20 |
| 1366040958 | Grace Wood | Counselor | 1621 E 6th St Apt 2212, Austin, TX 78702-3327 | 2020-10-15 |
| 1871191379 | Alexis Losch | Counselor | 13740 Research Blvd Ste L5, Austin, TX 78750-1833 | 2020-10-15 |
| 1518573880 | Brenda Lee Rodriguez | Counselor | 11001 S 1st St Apt 225, Austin, TX 78748-6765 | 2020-09-21 |
| 1174139794 | Julie Jackson | Counselor | 8208 Farmington Ct, Austin, TX 78736-1744 | 2020-09-18 |
| 1780290494 | Britney Juliane Watson | Counselor | 10701 S Interstate 35 Apt 113, Austin, TX 78747-1777 | 2020-09-17 |
| 1154936235 | David Barrett | Counselor | 2525 Wallingwood Dr Ste 216, Austin, TX 78746-6900 | 2020-09-15 |
| 1669084943 | Lutheran Social Services of The South, Inc. | Counselor | 10601 Derecho Drive, Austin, TX 78737-1013 | 2020-08-19 |
| Find all providers in AUSTIN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.