Marie Antoinette Fowler, LCSW
NPI 1255602470ActiveIndividual· Social Worker, Clinical· Victorville, CA
Social Worker, Clinical (LCSW) with Sud Specialty Group - Ca, practicing in Victorville, California. Enrolled in Medicare as practitioner - clinical social worker.
Overview
| NPI | 1255602470 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LCSW |
| Sole proprietor | Yes |
| NPI issued | Jan 19, 2012 |
| Last updated in NPPES | Jan 19, 2012 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | 23905 | CA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Social Worker (CA) |
|---|
Education and affiliations
| Graduation year | 2003 |
|---|---|
| Medicare specialty | Clinical Social Worker |
Medical group
- Sud Specialty Group - CaSanta Clara, CA · 568 clinicians
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