Active NPI
Carol Rene Fowler, PSYD
- Clinical Psychologist
- Fort Rucker, AL
National Provider Identifier
1023004884
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1277
- Practice address
- Sere Det, 1-145TH Avn Regt
BLDG 750, 3Rd Ave
Fort Rucker, AL 32326 - Phone
- (334) 255-0441
- NPI assigned
- Sep 26, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1277 | AL | Primary |
Addresses
Primary practice location
Sere Det, 1-145TH Avn Regt
BLDG 750, 3Rd Ave
Fort Rucker, AL 32326
Mailing address
302 Washington Ave
Enterprise, AL 36330-4411
Phone (334) 406-9778
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1277 | AL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1338940800000",
"number": "1023004884",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "302 WASHINGTON AVE",
"city": "ENTERPRISE",
"state": "AL",
"postal_code": "363304411",
"telephone_number": "334-406-9778"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "SERE DET, 1-145TH AVN REGT",
"address_2": "BLDG 750, 3RD AVE",
"city": "FORT RUCKER",
"state": "AL",
"postal_code": "32326",
"telephone_number": "334-255-0441"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOWLER",
"first_name": "CAROL",
"middle_name": "RENE",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-26",
"last_updated": "2012-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "AL",
"license": "1277",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Rucker, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.