Sandra Y Fowler, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C005605 Issued in NC

Practice address

3205 East Randolph Parkway
Suite 122
Wilmington, NC 28403

Phone

(252) 414-8101

NPI assigned

Mar 20, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1487779328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 PEPPERHILL RD",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284619782",
            "telephone_number": "910-477-1638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3205 EAST RANDOLPH PARKWAY",
            "address_2": "SUITE 122",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "28403",
            "telephone_number": "252-414-8101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "SANDRA",
        "middle_name": "Y",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C005605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlin Melissa Lessard Fowler
• Kirsty Fowler
• Lauren Fowler, LCSWA
• Regina Rylee Fowler
• Rian Taylor Fowler, PA-C
• Tanya L Fowler, PMHNP-BC
• Charles Andrew Fox, MD
• Elizabeth Ann Fox, RN
• Jeffrey W. Fox, L.AC.
• Malynda Irene Fox

• Clinical Social Worker in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; 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.