Ashlee Fowler, LMSW

Individual provider Active NPI Clinical Social Worker · Holt, MI

NPI 1871990002 · NPPES record last updated Feb 13, 2024

Key facts

NPI
1871990002
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
6801093602 (MI)
Practice address
3610 Laureate Drive
Holt, MI 48842
Phone
(231) 590-6305
NPI assigned
Dec 3, 2014
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
6801093602MIMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker
Group: 193400000X SINGLE SPECIALTY GROUP
1041C0700X 6801093602 MI Yes

Addresses

Primary practice location

3610 Laureate Drive
Holt, MI 48842

Mailing address

3003 E Michigan Ave Ste 1139
Lansing, MI 48912-4616

Other providers in Holt, MI

All providers in Holt, MI · Clinical Social Worker in Michigan

Sources for this page

Verify at the official NPI Registry.