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

Individual provider Mental Health Counselor · NPI 1063148690

Shakari Carson, LCSW is a Clinical Social Worker in Redmond, Oregon. Qualified in 2021, 5 years ago. Practices with Deschutes County Oregon, a 57-clinician group and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
5
Licensed in
OR
In the registry since
2022
Specialties on file
2
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

244 NW Kingwood Ave
Redmond, OR 97756-1688
Phone: (541) 322-7500
Fax: (541) 322-7565
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence L16679 (OR)
Mental Health Counselor Taxonomy 101YM0800X

Record details

NPI number1063148690
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedJuly 26, 2022
Last updated in NPPESJuly 16, 2025
Certification dateJuly 16, 2025
Mailing address2577 Ne Courtney Dr, Bend, OR 97701-7752

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Deschutes County Oregon — 57 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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