Individual provider Active NPI

Kristin C Fowles, LCSW

  • Clinical Social Worker
  • Newark, DE
National Provider Identifier
1598073827
Registry record updated Sep 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2010600831 Issued in DE
Practice address
11 Michael Townsend CT
Newark, DE 19702-1140
Phone
(801) 824-6037
Fax
(302) 368-1662
NPI assigned
Sep 21, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2010600831 DE Primary

Addresses

Primary practice location

11 Michael Townsend CT
Newark, DE 19702-1140

Mailing address

11 Michael Townsend CT
Newark, DE 19702-1140
Phone (801) 824-6037

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

LicenseStateTypeSpecialty
2010600831DEMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1285027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285027200000",
    "number": "1598073827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 MICHAEL TOWNSEND CT",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197021140",
            "telephone_number": "801-824-6037",
            "fax_number": "302-368-1662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 MICHAEL TOWNSEND CT",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197021140",
            "telephone_number": "801-824-6037",
            "fax_number": "302-368-1662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLES",
        "first_name": "KRISTIN",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-21",
        "last_updated": "2010-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DE",
            "license": "2010600831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2010; 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.