JESSICA FOWLER (MA, LMFT) – Marriage & Family Therapist, NPI 1538880497

JESSICA FOWLER (MA, LMFT) is a healthcare provider. based in Minnetonka, Minnesota. specializing in MARRIAGE AND FAMILY THERAPIST. They hold the professional credentials MA, LMFT. They hold a License No. 4379 (MN). The NPI Number for JESSICA FOWLER (MA, LMFT) is 1538880497

Main info

Female
Sole Proprietor
7 Years Of Experience
Accepts Medicare Assignment
Name
JESSICA FOWLER (MA, LMFT)
NPI
1538880497
Phone
(612) 716-0809
Address
5536 HOLIDAY RD
Enumeration Date
8 September 2022
Last Update Date
8 September 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6516411555
Graduation Year
2019 (7 years ago)
PAC ID
1658714274
Group Practice PAC ID
0941669576
Professional Enrollment ID
I20240209002921
Address ID
MN551043453ST1919XWXXX402
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:3State licenses:1Digital endpointsOther names

981 MARRIAGE AND FAMILY THERAPIST in MN

Provider Addresses for JESSICA FOWLER (MA, LMFT)

  • 5536 HOLIDAY RD

    MINNETONKA, MN 553455414

    Phone: (612) 716-0809

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-02-09

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240209002921IMarriage And Family TherapistMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55345)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0941669576View full group profile
NameSpecialtyState
Clinical Social WorkerMN
Clinical Social WorkerMN
Clinical PsychologistMN
Marriage And Family TherapistMN
Mental Health CounselorMN

Reviews

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Frequently asked questions

How is JESSICA FOWLER (MA, LMFT) identified in CMS data?
CMS-hosted NPPES data lists JESSICA FOWLER (MA, LMFT) with NPI 1538880497.
Is JESSICA FOWLER (MA, LMFT) listed as active for patients and plans?
The listing shows JESSICA FOWLER (MA, LMFT) as active in the NPI system.
What is JESSICA FOWLER (MA, LMFT)'s specialty?
The listing groups JESSICA FOWLER (MA, LMFT) with Marriage & Family Therapist. Clinical services aligned with this taxonomy classification.
What area does JESSICA FOWLER (MA, LMFT) serve?
JESSICA FOWLER (MA, LMFT)'s listing highlights Minnetonka, Minnesota; more addresses can appear in NPPES.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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