Active NPI
Erin Fowler, LCSW, CADC
- Clinical Social Worker
- Crystal Lake, IL
National Provider Identifier
1477193258
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149.025287
- Practice address
- 620 N State Route 31
Crystal Lake, IL 60012-3714 - Phone
- (815) 261-3450
- NPI assigned
- Jan 9, 2020
- Last updated
- Oct 30, 2023
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 31110 | IL | |
| Social Worker | 104100000X | |||
| Clinical Social Worker | 1041C0700X | 149.025287 | IL | Primary |
Addresses
Primary practice location
620 N State Route 31
Crystal Lake, IL 60012-3714
Mailing address
5401 W Dartmoor Dr Apt D
McHenry, IL 60050-5123
Phone (815) 546-4945
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31110 | IL | MD | Addiction (Substance Use Disorder) Counselor |
| 149.025287 | IL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northern Illinois Recovery LLC | Past | Accepting new patients | |
| Northern Illinois Recovery LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Substance Abuse Rehabilitation Facility
- Crystal Lake, IL
- NPI 1144000266
-
- Substance Abuse Rehabilitation Facility
- Crystal Lake, IL
- NPI 1518428226
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1578528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698624000000",
"number": "1477193258",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5401 W DARTMOOR DR APT D",
"city": "MCHENRY",
"state": "IL",
"postal_code": "600505123",
"telephone_number": "815-546-4945"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 N STATE ROUTE 31",
"city": "CRYSTAL LAKE",
"state": "IL",
"postal_code": "600123714",
"telephone_number": "815-261-3450"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOWLER",
"first_name": "ERIN",
"credential": "LCSW, CADC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-09",
"last_updated": "2023-10-30",
"certification_date": "2023-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "IL",
"license": "31110",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149.025287",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crystal Lake, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.