Active NPI
Jennifer J. Sowle, PHD
- Clinical Psychologist
- Traverse City, MI
National Provider Identifier
1245307370
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6301007636
- Practice address
- 236 1/2 E Front St
Traverse City, MI 49684-2526 - Phone
- (231) 946-6488
- Fax
- (231) 275-0153
- NPI assigned
- Nov 30, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6301007636 | MI | Primary |
Addresses
Primary practice location
236 1/2 E Front St
Traverse City, MI 49684-2526
Mailing address
PO Box 4249
Traverse City, MI 49685-4249
Phone (231) 946-6488
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301007636 | MI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1197331200000",
"number": "1245307370",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4249",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496854249",
"telephone_number": "231-946-6488",
"fax_number": "231-275-0153"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "236 1/2 E FRONT ST",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496842526",
"telephone_number": "231-946-6488",
"fax_number": "231-275-0153"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOWLE",
"first_name": "JENNIFER",
"middle_name": "J.",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-30",
"last_updated": "2007-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301007636",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Traverse City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2007; 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.