MS. JACQUELINE BERNICE FOWLER (NPI# 1053582445) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053582445 |
| Entity Type | Individual |
| Full Name | MS. JACQUELINE BERNICE FOWLER |
| Credential | HAPP, LMMT |
| Practice Address |
8620 Maple Ave Gary IN 46403-1423 |
| Practice Telephone | 2199632956 |
| Mailing Telephone | 2199632956 |
| Enumeration Date | 2008-03-13 |
| Last Update Date | 2012-11-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TP2701X |
Psychologist Specialization: Group Psychotherapy |
Behavioral Health & Social Service Providers | ||
| N | 171100000X | Acupuncturist | 00000 | IN | Other Service Providers |
| N | 175F00000X | Naturopath | Other Service Providers | ||
| N | 173C00000X | Reflexologist | Other Service Providers | ||
| N | 172M00000X | Mechanotherapist | IN | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | HOLISTIC ALTERNATIVE PSYCHOLOGY PRACTITIONER | 00000 | 01 |
| IN | LICENSED MASSAGE THERAPIST/ MECHANO THERAPIST | MT209011898 | 01 |
| Street Address |
8620 MAPLE AVE |
| City | GARY |
| State | IN |
| Zip Code | 46403-1423 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003172008 | Healthy Smiles Nwi | Dentist | 4629 Melton Rd., Gary, IN 46403 | 2012-04-04 |
| 1932494424 | Restore Therapy Services LLC | Physical Therapist | 6100 Miller Avenue, Gary, IN 46403 | 2011-06-13 |
| 1851682587 | Ladwana Retic | Social Worker | 4416 East 6th Avenue, Gary, IN 46403 | 2011-04-28 |
| 1962500298 | Lynn E Gassoway | Dentist | 8412 Maple Ave, Gary, IN 46403 | 2006-09-20 |
| 1376826867 | Jill Obrien | Pharmacist | 801 S Lake St, Gary, IN 46403 | 2011-09-21 |
| 1932314275 | Charter School of The Dunes | Local Education Agency (LEA) | 860 N Lake St, Gary, IN 46403-1070 | 2007-05-11 |
| 1598980542 | Arc Bridges, Inc | Custodial Care Facility | 7110 Forest Ave, Gary, IN 46403-1201 | 2007-04-16 |
| 1104039510 | Lynn E Gassoway,dds,inc | Clinic/Center | 8412 Maple Ave, Gary, IN 46403-1419 | 2007-05-08 |
| 1659484053 | Life Service Professional Corp | Specialist | 1015 N Shelby St, Gary, IN 46403-1446 | 2006-08-17 |
| 1497007876 | Community Healthnet | Clinic/Center | 1015 N Shelby St, Gary, IN 46403-1446 | 2012-10-09 |
| Find all providers in zip 46403 | ||||
| Taxonomy Code | 103TP2701X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Group Psychotherapy |
| Definition to come... |
| Notes: [1/1/2007: modified title] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134618333 | Heartland Behavioral Health Inc | Psychologist | 2068 Lucas Pkwy Ste 3, Lowell, IN 46356 | 2018-05-03 |
Please comment or provide details below to improve the information on MS. JACQUELINE BERNICE FOWLER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.