William C Fowle, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801012831 Issued in MI

Practice address

1719 S Garfield Ave
Traverse City, MI 49686-4337

Phone

(231) 935-0799

Fax

(231) 935-0962

NPI assigned

May 23, 2007

Sex

Male

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

Enrolled in MI

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

Specialty

Clinical Social Worker

Education

Other, 1976

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Old Town Psychological ServicesGroup PAC ID 2466600101, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Old Town Psychological Services

  • Clinical Psychologist
  • Traverse City, MI
  • NPI 1093989162
  Medicare reassignment Care Compare group NPD
• Old Town Psychological Services-Gaylord

  • Clinical Child & Adolescent Psychologist
  • Gaylord, MI
  • NPI 1750659249
  NPD (past)

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483574400000",
    "number": "1154531648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1719 S GARFIELD AVE",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496864337",
            "telephone_number": "231-935-0799",
            "fax_number": "231-935-0962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1719 S GARFIELD AVE",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496864337",
            "telephone_number": "231-935-0799",
            "fax_number": "231-935-0962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLE",
        "first_name": "WILLIAM",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2017-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801012831",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MI",
            "license": "4101005403",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Noel Fought
• Craig H Fountain, DDS
• Melissa Fournier, LMSW
• Neesha Elizabeth Fournier, MD
• Rachel Fournier, LPC
• Jill Marie Fowler, NP
• Cheryl Fox
• James Martin Fox, M.D.
• Merritt Fox, PA
• Ava Fraam

• Clinical Social Worker in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.