Active NPI
Michael Fowler, LMFT
- Marriage & Family Therapist
- Fort Worth, TX
National Provider Identifier
1982171047
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 203354
- Practice address
- 4616 Quarry Cir
Fort Worth, TX 76244-7903 - Phone
- (817) 707-0772
- NPI assigned
- Oct 26, 2018
- Sex
- Male
- Sole proprietor
- Yes
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 | 203354 | TX | Primary |
Addresses
Primary practice location
4616 Quarry Cir
Fort Worth, TX 76244-7903
Mailing address
4616 Quarry Cir
Fort Worth, TX 76244-7903
Phone (817) 707-0772
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 |
|---|---|---|---|
| 203354 | TX | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631577600000",
"number": "1982171047",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4616 QUARRY CIR",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "762447903",
"telephone_number": "817-707-0772"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4616 QUARRY CIR",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "762447903",
"telephone_number": "817-707-0772"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOWLER",
"first_name": "MICHAEL",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-10-26",
"last_updated": "2021-09-14",
"certification_date": "2020-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "TX",
"license": "203354",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.