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NPI Code Detail

MEDICARE: MR. WILLIAM C FOWLE LMSW

MEDICARE: MR. WILLIAM C FOWLE LMSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker6801012831MI
2106H00000XMarriage & Family Therapist4101005403MI

General Provider Information

NPI Number : 1154531648
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. WILLIAM C FOWLE LMSW
Provider Business Mailing Address
First Line : 1719 S GARFIELD AVE
Second Line :
City : TRAVERSE CITY
State : MI
Zip : 49686-4337
Country : US
Telephone Number : 231-935-0799
Fax Number : 231-935-0962
Provider Business Practice Location Address
First Line : 1719 S GARFIELD AVE
Second Line :
City : TRAVERSE CITY
State : MI
Zip : 49686-4337
Country : US
Telephone Number : 231-935-0799
Fax Number : 231-935-0962
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2007
Last Update Date : 01/05/2017

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Directions to “ MR. WILLIAM C FOWLE LMSW” Practice Location

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