Phillip Jeremy Dew, MA, LPC, EMMHS, CMHS

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

71786 Issued in TX

Practice address

2554 E Villa Maria Rd
Bryan, TX 77802-2037

Phone

(206) 669-8124

Fax

(979) 774-0316

NPI assigned

Jan 24, 2012

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Mar 5, 2025 through Mar 5, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Adam Saenz Group, P.C.

  • Psychologist
  • Bryan, TX
  • NPI 1972740686
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1327363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386201600000",
    "number": "1407127392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2554 E VILLA MARIA RD",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022037",
            "telephone_number": "206-669-8124",
            "fax_number": "979-774-0316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2554 E VILLA MARIA RD",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022037",
            "telephone_number": "206-669-8124",
            "fax_number": "979-774-0316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEW",
        "first_name": "PHILLIP",
        "middle_name": "JEREMY",
        "credential": "MA, LPC, EMMHS, CMHS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-24",
        "last_updated": "2013-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "71786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Joseph Derbes, M.D.
• April Dianne Derkowski, FNP-C
• Reena Desai
• Richard Devaul, M.D.
• Sydnei Devose-Fletcher, LMSW
• Stephanie Dewsnap, M.D.
• Shailesh D Dhaduk, M.D.
• Diagnostic Foot Specialists
• Dialysis Newco LLC (U.S. Renal Care Bryan Dialysis)
• Katelin Sue Dias, PHD

• Mental Health Counselor in Bryan, TX
• Providers in Bryan, TX by specialty
• Mental Health Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.