Active NPI
Catherine A'Vant-Fowler, LMHC, LCDP
- Mental Health Counselor
- Providence, RI
National Provider Identifier
1265446264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MHC00335
- Practice address
- 530 N Main St
Providence, RI 02904-5762 - Phone
- (401) 274-2500
- NPI assigned
- Jul 28, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LCDP00163 | RI | |
| Mental Health Counselor | 101YM0800X | MHC00335 | RI | Primary |
Addresses
Primary practice location
530 N Main St
Providence, RI 02904-5762
Mailing address
528 N Main St
Providence, RI 02904-5757
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CA55331 | Medicaid | RI | |
| 1104847946 | Other | RI | THE PROVIDENCE CENTER NPI |
| 414649 | Other | RI | B.CHIP |
| 62-89732 | Other | RI | UNITED BEHAVIORAL HEALTH |
| 33268-0 | Other | RI | B.CROSS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in RI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240207003541 | RI | Practitioner - Mental Health Counselor | 5698118586 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- The Providence Center Inc
Practice addresses (Care Compare)
530 N Main St
Providence, RI 02904-5762
Phone (401) 274-2500
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCDP00163 | RI | MD | Addiction (Substance Use Disorder) Counselor |
| MHC00335 | RI | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Providence Center Inc | Addiction (Substance Use Disorder) | Current | Accepting new patients |
| Affinity Physicians LLC. | Current | Accepting new patients | |
| The Providence Center | Past | Accepting new patients |
Locations
528 N Main St
Providence, RI 02904
Phone (401) 276-4020
530 N Main St
Providence, RI 02904
Phone (401) 274-2500
171 Service Ave
Warwick, RI 02886
Phone (401) 222-9157
Interoperability endpoints
- cavantfowler@direct.carene.org
Organizations & group practices 3
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Providence, RI
- NPI 1104847946
Addiction (Substance Use Disorder), RI
-
- Internal Medicine Physician
- Warwick, RI
- NPI 1184944662
-
- Community/Behavioral Health Agency
- Providence, RI
- NPI 1134977598
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321315200000",
"number": "1265446264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "528 N MAIN ST",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029045757"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "530 N MAIN ST",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029045762",
"telephone_number": "401-274-2500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "A'VANT-FOWLER",
"first_name": "CATHERINE",
"credential": "LMHC, LCDP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-28",
"last_updated": "2011-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "RI",
"license": "LCDP00163",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "RI",
"license": "MHC00335",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "CA55331",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "THE PROVIDENCE CENTER NPI",
"identifier": "1104847946",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "B.CHIP",
"identifier": "414649",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED BEHAVIORAL HEALTH",
"identifier": "62-89732",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "B.CROSS",
"identifier": "33268-0",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2011; 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.