Individual provider Active NPI

Clint A. Wheeler, LCSW

  • Clinical Social Worker
  • Knoxville, TN
National Provider Identifier
1023367562
Registry record updated May 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6473 Issued in TN
Practice address
10434 Jackson Oaks Way
Knoxville, TN 37922-3293
Phone
(865) 730-4171
Fax
(423) 388-4774
NPI assigned
Aug 30, 2012
Last updated
May 6, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6473 TN Primary

Addresses

Primary practice location

10434 Jackson Oaks Way
Knoxville, TN 37922-3293

Mailing address

27 6TH St
Bristol, TN 37620-2212
Phone (423) 573-6836

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Healthy Mind Counseling Services, Inc Clinical CurrentSince Jul 10, 2023 Accepting new patients
G. Michael Pilcher, Inc. Mental Health PastSince May 10, 2020 Accepting new patients

Locations

100 5th St
Ste 310
Bristol, TN 37620
Phone (423) 822-5099

10434 Jackson Oaks Way
Knoxville, TN 37922
Phone (865) 281-1408

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1346284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588723200000",
    "number": "1023367562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 6TH ST",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376202212",
            "telephone_number": "423-573-6836",
            "fax_number": "423-573-6836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10434 JACKSON OAKS WAY",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379223293",
            "telephone_number": "865-730-4171",
            "fax_number": "423-388-4774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEELER",
        "first_name": "CLINT",
        "middle_name": "A.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-30",
        "last_updated": "2020-05-06",
        "certification_date": "2020-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "6473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.