Individual provider Active NPI

Fabrienne Natasha McDowell, LMHC

  • Mental Health Counselor
  • Tampa, FL
National Provider Identifier
1861790073
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH 12487 Issued in FL
Practice address
4107 W Spruce St Ste 100
Tampa, FL 33607
Phone
(813) 636-8811
Fax
(813) 636-8855
NPI assigned
Mar 11, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH 12487 FL Primary

Addresses

Primary practice location

4107 W Spruce St Ste 100
Tampa, FL 33607

Mailing address

4107 W Spruce St Ste 100
Tampa, FL 33607-2346
Phone (813) 636-8811

Other practice location 1

8905 Regents Park Drive Suite 230
Tampa, FL 33647
Phone (813) 601-1293

Other identifiers 1

IdentifierTypeStateIssuer
016012800MedicaidFL

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
MH 12487FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1299801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1861790073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4107 W SPRUCE ST STE 100",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336072346",
            "telephone_number": "813-636-8811",
            "fax_number": "813-636-8855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4107 W SPRUCE ST STE 100",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33607",
            "telephone_number": "813-636-8811",
            "fax_number": "813-636-8855"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8905 Regents Park Drive Suite 230",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "33647",
            "country_code": "US",
            "telephone_number": "813-601-1293",
            "fax_number": "813-443-5795",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDOWELL",
        "first_name": "FABRIENNE",
        "middle_name": "NATASHA",
        "name_prefix": "Ms.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-11",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH 12487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016012800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; 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.