MEDICARE: MR. BRENT ANDREW DYER LPC, NCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	86336	TX

General Provider Information

NPI Number	:	1538895669
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BRENT ANDREW DYER LPC, NCC

Provider Business Mailing Address
First Line	:	18707 YORKSHIRE MANOR CT
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77379-5324
Country	:	US
Telephone Number	:	832-691-8313
Fax Number	:

Provider Business Practice Location Address
First Line	:	18707 YORKSHIRE MANOR CT
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77379-5324
Country	:	US
Telephone Number	:	832-691-8313
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2022
Last Update Date	:	10/09/2023

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