Active NPI
Michael Anthony Fowlkes, 101YM0800X
- Mental Health Counselor
- Landover, MD
National Provider Identifier
1497226385
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- CAC11019
- Practice address
- 906 Hill Rd Apt 201
Landover, MD 20785-4340 - Phone
- (771) 777-0516
- NPI assigned
- Dec 17, 2018
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CAC11019 | DC | Primary |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1019 | DC |
Addresses
Primary practice location
906 Hill Rd Apt 201
Landover, MD 20785-4340
Mailing address
906 Hill Rd Apt 201
Landover, MD 20785-4340
Phone (771) 777-0516
Other practice location 1
1320 Good Hope Rd SE
Washington, DC 20020-6912
Phone (202) 610-1886
Other practice location 2
2918 Minnesota Ave SE
Washington, DC 20019-1127
Phone (240) 375-1957
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 |
|---|---|---|---|
| 1019 | DC | MD | Addiction (Substance Use Disorder) Counselor |
| CAC11019 | DC | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1545004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725840000000",
"number": "1497226385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "906 HILL RD APT 201",
"city": "LANDOVER",
"state": "MD",
"postal_code": "207854340",
"telephone_number": "771-777-0516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "906 HILL RD APT 201",
"city": "LANDOVER",
"state": "MD",
"postal_code": "207854340",
"telephone_number": "771-777-0516"
}
],
"practiceLocations": [
{
"address_1": "1320 Good Hope Rd SE",
"address_purpose": "LOCATION",
"city": "Washington",
"state": "DC",
"postal_code": "200206912",
"country_code": "US",
"telephone_number": "202-610-1886",
"fax_number": "202-610-1887",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2918 Minnesota Ave SE",
"address_purpose": "LOCATION",
"city": "Washington",
"state": "DC",
"postal_code": "200191127",
"country_code": "US",
"telephone_number": "240-375-1957",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FOWLKES",
"first_name": "MICHAEL",
"middle_name": "ANTHONY",
"name_prefix": "Mr.",
"credential": "101YM0800X",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-12-17",
"last_updated": "2024-09-09",
"certification_date": "2024-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "DC",
"license": "CAC11019",
"primary": true
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "DC",
"license": "1019",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Landover, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.