Active NPI
Sean M Fowler, PSYD
- Psychologist
- Fort Bragg, NC
National Provider Identifier
1376078402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 5210
- 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
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 |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 5210 | NC | MD | Gerontology 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.