Individual provider Active NPI

Elizabeth Ann Fowler, LPC

  • Professional Counselor
  • Jacksonville, AR
National Provider Identifier
1972175834
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
2126 N 1St St
Ste F
Jacksonville, AR 72076-2868
Phone
(501) 982-5000
Fax
(501) 982-5007
NPI assigned
Jul 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X Primary
Counselor 101Y00000X A2106020 AR

Addresses

Primary practice location

2126 N 1St St
Ste F
Jacksonville, AR 72076-2868

Mailing address

1815 Pleasant Grove Rd
Jonesboro, AR 72405-7870
Phone (870) 933-6886

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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

Enrollment IDStateProvider typePAC IDDetails
I20240710003811 AR Practitioner - Mental Health Counselor 7719422070 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A2106020ARMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Sparkfit Community Inc Professional CurrentSince Oct 1, 2024 Accepting new patients
Families, Inc of Arkansas CurrentSince May 1, 2024 Accepting new patients
Families, Inc. of Arkansas Counselor CurrentSince May 1, 2024 Accepting new patients

Locations

1815 Pleasant Grove Rd
Jonesboro, AR 72405
Phone (870) 833-6886

2126 N 1st St
Ste F
Little Rock AFB, AR 72076
Phone (501) 982-5000

2500 Lakeview Rd
North Little Rock, AR 72116
Phone (501) 322-3374

1425 W Main St
Walnut Ridge, AR 72476
Phone (870) 886-5303

Organizations & group practices 3

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": "1626048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1972175834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 PLEASANT GROVE RD",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724057870",
            "telephone_number": "870-933-6886",
            "fax_number": "870-336-1339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2126 N 1ST ST",
            "address_2": "STE F",
            "city": "JACKSONVILLE",
            "state": "AR",
            "postal_code": "720762868",
            "telephone_number": "501-982-5000",
            "fax_number": "501-982-5007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-12",
        "last_updated": "2024-06-06",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "AR",
            "license": "A2106020",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, AR

Sources for this page

Verify at the official NPI Registry.