Individual provider Active NPI

Hannah Marie Fowler, TLMFT

  • Marriage & Family Therapist
  • Bettendorf, IA
National Provider Identifier
1861160129
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
109151 Issued in IA
Practice address
3625 Utica Ridge Rd Ste F
Bettendorf, IA 52722-1653
Phone
(675) 056-3359
NPI assigned
Sep 1, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 109151 IA Primary

Addresses

Primary practice location

3625 Utica Ridge Rd Ste F
Bettendorf, IA 52722-1653

Mailing address

3715 5TH Ave Apt 1
Moline, IL 61265-1622
Phone (309) 749-9665

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
109151IAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Life Connection, L.C. CurrentSince Sep 5, 2021 Accepting new patients

Locations

3625 Utica Ridge Rd
Ste F
Bettendorf, IA 52722
Phone (563) 293-6575

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": "1630454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1861160129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3715 5TH AVE APT 1",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612651622",
            "telephone_number": "309-749-9665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 UTICA RIDGE RD STE F",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527221653",
            "telephone_number": "675-056-3359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "HANNAH",
        "middle_name": "MARIE",
        "credential": "TLMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-01",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IA",
            "license": "109151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bettendorf, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; 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.