Melissa Fowler, LCSW – Clinical Social Worker

Key facts

NPI: 1023797339
Entity type: Individual (NPI type 1)
Primary specialty: Clinical Social Worker 1041C0700X
License: 8725 (TN)
Practice address: 4120 Fayette Corner Dr
Somerville, TN 38068-4320
Phone: (406) 579-8620
NPI assigned: Jul 13, 2023
Sex: Female
Sole proprietor: No

Organizations & group practices 1

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.

Utm of Georgia Physicians LLC Family Medicine Physician · Fort Oglethorpe, GA · NPI 1255893038

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No
Credentials: Master of Science

State licenses

License	State	Type	Specialty
8725	TN	MD	General Practice Dentistry

Practice roles

Organization	Specialty	Status	New patients
Utm of Georgia Physicians LLC		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Clinical Social Worker	1041C0700X	8725	TN	Yes

Addresses

Primary practice location

4120 Fayette Corner Dr
Somerville, TN 38068-4320

Mailing address

11100 Old Highway 64 West
Bolivar, TN 38008
Phone (731) 228-0741

Other practice location 1

11100 Old Highway 64 West
Bolivar, TN 38008
Phone (731) 228-0741

Other providers in Somerville, TN

All providers in Somerville, TN · Clinical Social Worker in Tennessee

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2023. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.