Active NPI
Stephania Marice Fowler
- Mental Health Counselor
- Little Rock, AR
National Provider Identifier
1114210564
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 6450 West 12TH
Little Rock, AR 72204 - Phone
- (501) 666-8686
- NPI assigned
- May 18, 2011
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
6450 West 12TH
Little Rock, AR 72204
Mailing address
356 E Bolling Ave
Monticello, AR 71655-5606
Phone (501) 666-8686
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1305676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1305676800000",
"number": "1114210564",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "356 E BOLLING AVE",
"city": "MONTICELLO",
"state": "AR",
"postal_code": "716555606",
"telephone_number": "501-666-8686"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6450 WEST 12TH",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "72204",
"telephone_number": "501-666-8686"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOWLER",
"first_name": "STEPHANIA",
"middle_name": "MARICE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-05-18",
"last_updated": "2011-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Little Rock, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.