MEDICARE: DYLAN PHILLIPS LPC

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	101YP2500X	Professional Counselor	81701	TX

General Provider Information

NPI Number	:	1568946606
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DYLAN PHILLIPS LPC

Provider Business Mailing Address
First Line	:	655 AIRPORT RD
Second Line	:
City	:	SULPHUR SPRINGS
State	:	TX
Zip	:	75482-2009
Country	:	US
Telephone Number	:	39-438-3270
Fax Number	:

Provider Business Practice Location Address
First Line	:	655 AIRPORT RD
Second Line	:
City	:	SULPHUR SPRINGS
State	:	TX
Zip	:	75482-2009
Country	:	US
Telephone Number	:	903-438-3270
Fax Number	:

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

Provider Enumeration Date	:	09/24/2018
Last Update Date	:	09/28/2023

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Directions to “ DYLAN PHILLIPS LPC” Practice Location

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