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

Mrs. Carly Blake Shannon, LPC

Individual provider Professional Counselor · NPI 1407001258

Mrs. Carly Blake Shannon, LPC is a Mental Health Counselor in Dallas, Texas. Graduated from University of North Texas Hsc, College of Osteopathic Med in 2006, 20 years ago. Practices with Deep Eddy Psychotherapy Management, LLC, a 77-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Texas.

Years since qualifying
20
Trained at
University of North Texas Hsc, College of Osteopathic Med
Licensed in
TX
In the registry since
2008
What do these letters mean?
LPC — Licensed Professional Counselor
A licensed mental health counsellor.

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Practice location Address checks out

4144 N Central Expy Ste 850
Dallas, TX 75204-3226
Phone: (512) 956-6463
Fax: (866) 653-5142
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 62456 (TX)

Record details

NPI number1407001258
Entity typeIndividual (Type 1)
GenderFemale
Credentials LPC
Sole proprietorNo
NPI enumeratedNovember 20, 2008
Last updated in NPPESSeptember 18, 2025
Certification dateSeptember 18, 2025

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolUNIVERSITY OF NORTH TEXAS HSC, COLLEGE OF OSTEOPATHIC MED
Graduated 2006 (20 years in practice)
Group practice Deep Eddy Psychotherapy Management, Llc — 77 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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