Provider Demographics
NPI:1467060863
Name:FOWLER, ERIN DAVIS (MA, LPC-MHSP)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:DAVIS
Last Name:FOWLER
Suffix:
Gender:F
Credentials:MA, LPC-MHSP
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:FOWLER
Other - Last Name:HATCLIFF
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, LPC-MHSP
Mailing Address - Street 1:3914 SAINT ELMO AVE
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37409-1268
Mailing Address - Country:US
Mailing Address - Phone:423-225-2671
Mailing Address - Fax:
Practice Address - Street 1:3914 SAINT ELMO AVE
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37409-1268
Practice Address - Country:US
Practice Address - Phone:423-225-2671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-21
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7203101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health