Healthcare Provider Details

I. General information

NPI: 1760713499
Provider Name (Legal Business Name): MARGARET FOWEE MSW, LCSW, LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2010
Last Update Date: 07/15/2022
Certification Date: 07/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

184 TRIANNA DR
ST AUGUSTINE FL
32086
US

IV. Provider business mailing address

99 KING ST UNIT 1082
ST AUGUSTINE FL
32085-7746
US

V. Phone/Fax

Practice location:
  • Phone: 904-323-1578
  • Fax:
Mailing address:
  • Phone: 904-323-1578
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLCDCIII.081078
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.1200249-SUPV
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW10698
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: