Derrick Fowler, MSRC, LCAS, LCMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

13130 Issued in NC

Practice address

2602 Eric LN Ste D3
Burlington, NC 27215-5076

Phone

(336) 520-2270

Fax

(336) 800-3735

NPI assigned

Sep 16, 2014

Last updated

Mar 13, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Acceptance Counseling Services, PLLC

  dba Acceptance Counseling

  • Psychoanalyst
  • Burlington, NC
  • NPI 1821941881

  Addiction (Substance Use Disorder)

  NPD Authorized official

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

{
    "created_epoch": "1410825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1518369065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2602 ERIC LN STE D3",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272155076",
            "telephone_number": "336-520-2270",
            "fax_number": "336-800-3735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2602 ERIC LN STE D3",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272155076",
            "telephone_number": "336-520-2270",
            "fax_number": "336-800-3735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "DERRICK",
        "credential": "MSRC, LCAS, LCMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-16",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "3549",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "13130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joynettia A Foster, LPC
• Crystal Hunter Foust
• Katy Foust, FNP-BC
• Fowler Family Care, Inc.
• Cassandra Ann Fowler, LCMHCA
• Justin Allen Fowler, D.P.M
• Renita Richmond Foxx, LCMHC, LCAS, CCS
• Lisa Franklin, LCASA
• Dorenza Theresa Frederick Joyce, LCMHCA, NCC
• Sarah Joy Free, CNM

• Mental Health Counselor in Burlington, NC
• Providers in Burlington, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 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.