Eola Shelly Fowler

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LCSW-22881 Issued in AZ

Practice address

3505 Western Ave
Kingman, AZ 86409-3071

Phone

(928) 757-8111

NPI assigned

Jan 18, 2019

Last updated

Apr 9, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Next Door Counseling

  • Marriage & Family Therapist
  • Laguna Hills, CA
  • NPI 1730306424
  NPD (past)

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

{
    "created_epoch": "1547769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1114491537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3784 E SNAVELY BAY",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864090850",
            "telephone_number": "775-309-3351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 WESTERN AVE",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864093071",
            "telephone_number": "928-757-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "EOLA",
        "middle_name": "SHELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-18",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "LIAC-155347",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LCSW-22881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Suzanne Florea, NP
• Linda S Flores, C.O.T.A.
• Marcie Helene Foster, M.ED., ED.S., NCSP
• Stephen C Foster
• Founders Healthcare, LLC (Preferred Homecare)
• Ruth Elaine Fowler, FNP/BC
• Bradley Fox, NP-C
• Ruth Anne Franco, NURSE PRACTITIONER
• Ethan Franzen, DO
• Fredonia Medical Center, Inc

• Mental Health Counselor in Kingman, AZ
• Providers in Kingman, AZ by specialty
• Mental Health Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.