Individual provider Active NPI

Sean M Fowler, PSYD

  • Psychologist
  • Fort Bragg, NC
National Provider Identifier
1376078402
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
5210 Issued in NC
Practice address
2817 Rock Merritt Ave
Fort Bragg, NC 28310-0001
Phone
(910) 907-8922
Fax
(910) 907-6069
NPI assigned
Apr 26, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 5210 NC
Psychologist 103T00000X 5210 NC Primary

Addresses

Primary practice location

2817 Rock Merritt Ave
Fort Bragg, NC 28310-0001

Mailing address

2817 Rock Merritt Ave
Fort Bragg, NC 28310-0001
Phone (910) 907-8922

Other practice location 1

90 Southside Ave Ste 350
Asheville, NC 28801
Phone (954) 377-3094

Other practice location 2

173 Cornel Ln
Hampstead, NC 28443-7230
Phone (704) 495-6385

Other practice location 3

305 4th St SW
Hickory, NC 28602-2820
Phone (828) 270-3840

Other practice location 4

333 Trinity Rd
Statesville, NC 28625
Phone (704) 880-6306

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
5210NCMDGerontology Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1493164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1376078402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 ROCK MERRITT AVE",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283100001",
            "telephone_number": "910-907-8922",
            "fax_number": "910-907-6069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 ROCK MERRITT AVE",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283100001",
            "telephone_number": "910-907-8922",
            "fax_number": "910-907-6069"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "90 Southside Ave Ste 350",
            "address_purpose": "LOCATION",
            "city": "Asheville",
            "state": "NC",
            "postal_code": "28801",
            "country_code": "US",
            "telephone_number": "954-377-3094",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "173 Cornel Ln",
            "address_purpose": "LOCATION",
            "city": "Hampstead",
            "state": "NC",
            "postal_code": "284437230",
            "country_code": "US",
            "telephone_number": "704-495-6385",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "305 4th St SW",
            "address_purpose": "LOCATION",
            "city": "Hickory",
            "state": "NC",
            "postal_code": "286022820",
            "country_code": "US",
            "telephone_number": "828-270-3840",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "333 Trinity Rd",
            "address_purpose": "LOCATION",
            "city": "Statesville",
            "state": "NC",
            "postal_code": "28625",
            "country_code": "US",
            "telephone_number": "704-880-6306",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "SEAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-26",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "5210",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "5210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Bragg, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 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.