Alegra N Fowler, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

9136-123 Issued in WI

Practice address

102 E Green Bay St Ste 101
Shawano, WI 54166-2444

Phone

(715) 280-8130

Fax

(715) 280-8138

NPI assigned

Jul 25, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Sweetgrass Behavioral Health

  • Adolescent and Children Mental Health Clinic/Center
  • Shawano, WI
  • NPI 1508574328
  Medicare reassignment NPD Authorized official
• Little Minds Wellness LLC

  • Clinical Social Worker
  • Shawano, WI
  • NPI 1629915608
  NPD (past)

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

{
    "created_epoch": "1564012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670457600000",
    "number": "1962056382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 E GREEN BAY ST STE 101",
            "city": "SHAWANO",
            "state": "WI",
            "postal_code": "541662444",
            "telephone_number": "715-280-8130",
            "fax_number": "715-280-8138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 E GREEN BAY ST STE 101",
            "city": "SHAWANO",
            "state": "WI",
            "postal_code": "541662444",
            "telephone_number": "715-280-8130",
            "fax_number": "715-280-8138"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2640 West Point Rd",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543041344",
            "country_code": "US",
            "telephone_number": "920-490-3790",
            "fax_number": "920-490-3858",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "ALEGRA",
        "middle_name": "N",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-25",
        "last_updated": "2022-12-08",
        "certification_date": "2022-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "9136-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1637",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristin Nichol Floss, MS, BCBA
• Timothy J. Flynn, M.S.
• Forefront Dermatology, S.C.
• Forefront Dermatology, S.C.
• Forefront Dermatology, S.C.
• Fox Valley Hematology & Oncology, S.C.
• Jennifer Marie Franke, MS, LPC
• Susan Franke, PA
• Fresenius Medical Care Shawano, LLC
• Mindy Maria Frimodig, DO

• Clinical Social Worker in Shawano, WI
• Providers in Shawano, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.