PHYLLIS ANN DICKENSON
NPI 1811524382
Counselor - Mental Health in Bellevue, WA

Active since March 25, 2020Opted out of Medicare · through Jan 1, 2028
2105 112TH AVE NE STE 200, BELLEVUE, WA 98004(408) 761-3766 Get Directions Write a Review

NPPES record last updated: July 10, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 10, 2024, Feb 17, 2022, Mar 25, 2020 (3 updates tracked since 2020).

About Phyllis Ann Dickenson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PHYLLIS ANN DICKENSON (NPI 1811524382) is an individual mental health provider in Bellevue, Washington, licensed in Washington (MC61033567) and active in the NPI registry since March 2020. She has opted out of Medicare through January 1, 2028.

NPPES Registry Identity

NPI1811524382
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NamePHYLLIS ANN DICKENSON
Location Address2105 112TH AVE NE STE 200Bellevue, WA 98004-2945
Mailing Address2105 112th Ave Ne Ste 200Bellevue, WA 98004-2945 · (408) 761-3766
Sole ProprietorNo
Enumeration DateMarch 25, 2020
Last NPPES UpdateJuly 10, 20243 updates tracked since enumeration
NPPES CertifiedJuly 10, 2024
NPI 1811524382 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License Licensed in WA · MC61033567
2105 112TH AVE NE STE 200, Bellevue, WA 98004

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Phyllis Ann Dickenson has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 1, 2024 through January 1, 2028.

Opt-Out Effective DateJanuary 1, 2024
Opt-Out In Effect ThroughJanuary 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor (Professional)
2105 112TH AVE NE STE 200
BELLEVUE, WA 98004
Marriage & Family Therapist
2105 112TH AVE NE STE 200
BELLEVUE, WA 98004
Psychologist (Counseling)
2105 112TH AVE NE STE 200
BELLEVUE, WA 98004
Psychiatry & Neurology (Psychiatry)
2105 112TH AVE NE STE 200
BELLEVUE, WA 98004
Psychologist
2105 112TH AVE NE STE 200
BELLEVUE, WA 98004
Marriage & Family Therapist
2105 112TH AVE NE STE 200
BELLEVUE, WA 98004
Social Worker (Clinical)
2105 112TH AVE NE STE 200
BELLEVUE, WA 98004
Clinic/Center
2105 112TH AVE NE STE 200
BELLEVUE, WA 98004

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Phyllis Dickenson's NPI number?

The NPI number for Phyllis Dickenson is 1811524382. It was assigned to this individual provider in the NPPES registry on March 25, 2020.

Where is Phyllis Dickenson located?

Phyllis Dickenson practices at 2105 112th Ave NE Ste 200, Bellevue, WA 98004. The listed phone number is (408) 761-3766.

What is Phyllis Dickenson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Phyllis Dickenson enrolled in Medicare?

No. Phyllis Dickenson has opted out of Medicare through January 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

What insurance does Phyllis Dickenson accept?

Health plans from Premera Blue Cross Blue Shield of Alaska list Phyllis Dickenson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Phyllis Dickenson was last updated on July 10, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.