Active NPI
Hannah Marie Fowler, TLMFT
- Marriage & Family Therapist
- Bettendorf, IA
National Provider Identifier
1861160129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 109151
- 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
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 |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 109151 | IA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Life Connection, L.C. | Current | 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.
-
- Early Intervention Provider Agency
- Cedar Rapids, IA
- NPI 1538300892
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.