Jeb Thomas Fowler, PH.D.

Primary specialty

Psychoanalysis PsychologistTaxonomy code 103TP0814X

License

10122 Issued in MA

Practice address

1 Arnold Cir Ste 7
Cambridge, MA 02139-2250

Phone

(617) 444-9513

NPI assigned

Jun 8, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2023 through Jan 1, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Durham Fowler Psychotherapy Inc

  • Psychoanalysis Psychologist
  • Sherborn, MA
  • NPI 1689531964
  NPD Authorized official

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

{
    "created_epoch": "1244419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449187200000",
    "number": "1023244852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 BARTLETT CRES # 1",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024462208",
            "telephone_number": "617-444-9513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ARNOLD CIR STE 7",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021392250",
            "telephone_number": "617-444-9513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "JEB",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-08",
        "last_updated": "2015-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TP0814X",
            "taxonomy_group": "",
            "desc": "Psychologist, Psychoanalysis",
            "state": "MA",
            "license": "10122",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MA",
            "license": "10122",
            "primary": false
        },
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": "MA",
            "license": "10122",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Magdalena J. Fosse, M.A., M.S., PSYD
• Caitlin Foster, MD, MSC
• Rosalie A Foster, PTA
• Foundation Medicine, Inc.
• Linda Ann Fournier, RN
• Cassandra Fox, RN, FNP-C
• Irving H Fox, M.D.
• Lisa J Fox
• Margaret Koepke Fox, PH.D.
• Marian Joan Fox, MSW LICSW

• Psychoanalysis Psychologist in Cambridge, MA
• Providers in Cambridge, MA by specialty
• Psychoanalysis Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.