Provider Demographics
NPI:1295471357
Name:FOWLER, CHRISTI (MS, NCC, LPC)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTI
Middle Name:
Last Name:FOWLER
Suffix:
Gender:F
Credentials:MS, NCC, LPC
Other - Prefix:MS
Other - First Name:CHRISTI
Other - Middle Name:
Other - Last Name:PHILLIPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3900 HALL AVE STE C
Mailing Address - Street 2:
Mailing Address - City:MARINETTE
Mailing Address - State:WI
Mailing Address - Zip Code:54143-1062
Mailing Address - Country:US
Mailing Address - Phone:715-735-7802
Mailing Address - Fax:
Practice Address - Street 1:15397 STATE HIGHWAY 32
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WI
Practice Address - Zip Code:54138-9702
Practice Address - Country:US
Practice Address - Phone:715-276-6321
Practice Address - Fax:715-276-1428
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-10
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8563-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional