Provider Demographics
NPI:1376697136
Name:FOWLER, LINDSEY (LPC)
Entity Type:Individual
Prefix:MS
First Name:LINDSEY
Middle Name:
Last Name:FOWLER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5204 THUNDERBIRD TRL
Mailing Address - Street 2:
Mailing Address - City:GRANBURY
Mailing Address - State:TX
Mailing Address - Zip Code:76049-5305
Mailing Address - Country:US
Mailing Address - Phone:940-366-4700
Mailing Address - Fax:
Practice Address - Street 1:5204 THUNDERBIRD TRL
Practice Address - Street 2:
Practice Address - City:GRANBURY
Practice Address - State:TX
Practice Address - Zip Code:76049-5305
Practice Address - Country:US
Practice Address - Phone:940-366-4700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61187101YP2500X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional