Individual provider Active NPI

Sherry Haferkamp-Watson, PSY.D.

  • Clinical Psychologist
  • Brenham, TX
National Provider Identifier
1992167514
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
37193 Issued in TX
Practice address
1600 S Day St
Brenham, TX 77833-4828
Phone
(979) 777-1683
NPI assigned
Mar 23, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 37193 TX Primary

Addresses

Primary practice location

1600 S Day St
Brenham, TX 77833-4828

Mailing address

600 Walnut Hill Dr
Brenham, TX 77833-4986
Phone (979) 777-1683

Other practice location 1

2748 Longmire Dr
College Station, TX 77845-5424
Phone (979) 777-1683

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161021001094 TX Practitioner - Clinical Psychologist 3173801354 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1600 S Day St
Brenham, TX 77833-4828
Phone (979) 777-1683

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Brazos Valley Mental Health and Wellness, LLC Clinical CurrentSince Apr 14, 2017 Accepting new patients

Locations

1600 S Day St
Brenham, TX 77833
Phone (979) 777-1683

2554 E Villa Maria Rd
Bryan, TX 77802
Phone (979) 229-7636

2748 Longmire Dr
College Station, TX 77845
Phone (979) 777-1683

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1458691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1992167514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 WALNUT HILL DR",
            "city": "BRENHAM",
            "state": "TX",
            "postal_code": "778334986",
            "telephone_number": "979-777-1683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 S DAY ST",
            "city": "BRENHAM",
            "state": "TX",
            "postal_code": "778334828",
            "telephone_number": "979-777-1683"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2748 Longmire Dr",
            "address_purpose": "LOCATION",
            "city": "College Station",
            "state": "TX",
            "postal_code": "778455424",
            "country_code": "US",
            "telephone_number": "979-777-1683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAFERKAMP-WATSON",
        "first_name": "SHERRY",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-23",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "37193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brenham, TX

Sources for this page

Verify at the official NPI Registry.