Active NPI
William Frederick Reynolds, LCSW
- Clinical Social Worker
- Chattanooga, TN
National Provider Identifier
1003975186
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LSW0000000480
- Practice address
- 1312 Hanover St Ste B
Chattanooga, TN 37405-4353 - Phone
- (423) 756-2443
- NPI assigned
- Dec 6, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LSW0000000480 | TN | Primary |
Addresses
Primary practice location
1312 Hanover St Ste B
Chattanooga, TN 37405-4353
Mailing address
3529 Dell TRL
Chattanooga, TN 37411-4410
Phone (423) 624-6821
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LSW0000000480 | TN | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311552000000",
"number": "1003975186",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3529 DELL TRL",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374114410",
"telephone_number": "423-624-6821"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1312 HANOVER ST STE B",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374054353",
"telephone_number": "423-756-2443"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOLDS",
"first_name": "WILLIAM",
"middle_name": "FREDERICK",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-06",
"last_updated": "2011-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TN",
"license": "LSW0000000480",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chattanooga, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.