Active NPI
Bryan Lynn Fowler, LLMSW
- Clinical Social Worker
- Detroit, MI
National Provider Identifier
1669699856
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801087382
- Practice address
- 220 Bagley Ste 1100
Detroit, MI 48266-0001 - Phone
- (313) 961-7990
- Fax
- (313) 961-6274
- NPI assigned
- Apr 19, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801087382 | MI | Primary |
Addresses
Primary practice location
220 Bagley Ste 1100
Detroit, MI 48266-0001
Mailing address
43100 12 Oaks Crescent Dr Apt 6011
Novi, MI 48377-3438
Phone (734) 730-2007
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 |
|---|---|---|---|
| 6801087382 | MI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Neighborhood Service Organization | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Detroit, MI
- NPI 1891825808
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1669699856",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "43100 12 OAKS CRESCENT DR APT 6011",
"city": "NOVI",
"state": "MI",
"postal_code": "483773438",
"telephone_number": "734-730-2007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 BAGLEY STE 1100",
"city": "DETROIT",
"state": "MI",
"postal_code": "482660001",
"telephone_number": "313-961-7990",
"fax_number": "313-961-6274"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOWLER",
"first_name": "BRYAN",
"middle_name": "LYNN",
"name_prefix": "Mr.",
"credential": "LLMSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801087382",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.