Individual provider Active NPI

Stephanie Fowler, LCPC, CADC

  • Mental Health Counselor
  • Chicago, IL
National Provider Identifier
1770954877
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
180.010215 Issued in IL
Practice address
4305 N Lincoln Ave Ste L
Chicago, IL 60618-1807
Phone
(773) 669-4975
Fax
(844) 669-3667
NPI assigned
Oct 14, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 180.010215 IL Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 29760 IL

Addresses

Primary practice location

4305 N Lincoln Ave Ste L
Chicago, IL 60618-1807

Mailing address

4305 N Lincoln Ave Ste L
Chicago, IL 60618-1807
Phone (773) 669-4975

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
29760ILMDAddiction (Substance Use Disorder) Counselor
180.010215ILMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Inkwell Psychotherapy Addiction (Substance Use Disorder) Current Accepting new patients

Locations

4305 N Lincoln Ave
Ste L
Chicago, IL 60618
Phone (773) 420-7944

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.

NPI Registry JSON

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

{
    "created_epoch": "1444780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1770954877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4305 N LINCOLN AVE STE L",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606181807",
            "telephone_number": "773-669-4975",
            "fax_number": "844-669-3667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4305 N LINCOLN AVE STE L",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606181807",
            "telephone_number": "773-669-4975",
            "fax_number": "844-669-3667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "STEPHANIE",
        "credential": "LCPC, CADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-14",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.010215",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "29760",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2026; 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.