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Shelley M Dickason , QMHA

Case Manager/Care Coordinator β€’ La Pine, OR

Active NPI 1124515184 Individual Practitioner Female Practitioner
Practice location in NPPES

51340 Highway 97
La Pine, OR 977399871

Call 5413227500 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

51340 Highway 97

La Pine, OR 977399871

Telephone 5413227500
Fax 5413227565
Organization at the Same NPPES Address or Phone
Deschutes County Behavioral Health Facility NPI 1114204146

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

NPPES lists 1 additional practice-address record in Bend, OR. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

NPI first issued

2018

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in La Pine and Oregon

3 active clinicians are listed under Case Manager/Care Coordinator with a practice address in La Pine, OR (4,193 in Oregon).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2023-04-27
Case Manager/Care Coordinator Primary Specialty

NUCC Taxonomy Code: 171M00000X

A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee's progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management.

Counselor - Mental Health

NUCC Taxonomy Code: 101YM0800X

License # reported to NPPES OR 19-QMHA-I-00890
Counselor - Mental Health

NUCC Taxonomy Code: 101YM0800X

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Oregon Medical Board.
Look Up on State Board Site

Secondary Practice Locations

20370 Poe Sholes Dr

Bend, OR 977037938

Phone: 5413181377

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

3 listed
Emma Anderson , LCSW

Social Worker - Clinical

NPI 1023459591

Licensed Clinical Social Worker

Brian Fulmer

Psychiatry & Neurology - Psychiatry

NPI 1033572573
Lindsey Hurtado

Nurse Practitioner - Psychiatric/Mental Health

NPI 1003500836

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

12 Historical Events
πŸ“
Updated Practice Location April 27, 2023

Registered at 51340 HIGHWAY 97, LA PINE, OR 977399871 (Tel: 5413227500)

πŸ“
Updated Business Mailing Address April 27, 2023

Registered at 2577 NE COURTNEY DR, BEND, OR 977017752 (Tel: 5413227500)

πŸ‘€
Provider Name / Credentials Updated April 27, 2023

Recorded as SHELLEY DICKASON, QMHA

πŸ“
Updated Practice Location March 19, 2020

Registered at 20370 POE SHOLES DR, BEND, OR 977037938 (Tel: 5413181377)

πŸ“
Updated Business Mailing Address March 19, 2020

Registered at 20370 POE SHOLES DR, BEND, OR 977037938 (Tel: 5413181377)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) March 19, 2020

Counselor (license number reported to NPPES: OR 19-QMHA-I-00890)

βœ…
NPI Profile Active April 16, 2018

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) April 16, 2018

Registered at 2222 COBURG RD STE 100, EUGENE, OR 974014988 (Tel: 4582102984)

πŸ“
Business Mailing Address (Initial Record) April 16, 2018

Registered at 3587 HEATHROW WAY, MEDFORD, OR 975044004 (Tel: 5418588170)

πŸ‘€
Provider Name / Credentials (Initial Record) April 16, 2018

Recorded as SHELLEY DICKASON

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) April 16, 2018

Counselor

🟒
Initial NPI Registration & Enumeration April 16, 2018

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1124515184
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 16, 2018
Last Update: April 27, 2023
Sole Proprietor: No

Mailing Address

2577 Ne Courtney Dr

Bend, OR 977017752

Phone: 5413227500

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.