Phoenix K Fowler, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

256081 Issued in KY

Practice address

11103 Park Rd
Louisville, KY 40223-2424

Phone

(502) 589-8600

NPI assigned

Oct 14, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Seven Counties Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Louisville, KY
  • NPI 1598793671

  Social Worker

  Medicare reassignment NPD

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

{
    "created_epoch": "1634169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634169600000",
    "number": "1104589498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10401 LINN STATION RD STE 100",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402233842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11103 PARK RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402232424",
            "telephone_number": "502-589-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "PHOENIX",
        "middle_name": "K",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-14",
        "last_updated": "2021-10-14",
        "certification_date": "2021-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "256081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Rose Fowler
• Jeremy David Fowler, O.D.
• Joseph F Fowler Jr., M.D.
• Kristin Kellen Fowler, MSPT
• Morgan Elizabeth Fowler, RD
• Fox Access LLC
• Fox Rehabilitation Services Ky LLC
• Andrew Gregory Fox, MD
• Beth Ann Fox, PT
• Cambri Luann Fox, DO

• Clinical Social Worker in Louisville, KY
• Providers in Louisville, KY by specialty
• Clinical Social Worker in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.