Individual provider Active NPI

Matthew Crescenzi, LCSW

  • Clinical Social Worker
  • Knoxville, TN
National Provider Identifier
1124402755
Registry record updated Sep 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LSW0000007127 Issued in TN
Practice address
10805 Kingston Pike Ste 110
Knoxville, TN 37934-3064
Phone
(865) 800-8626
Fax
(865) 999-1405
NPI assigned
Jul 14, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 7127 TN
Professional Counselor 101YP2500X
Case Manager/Care Coordinator 171M00000X
Clinical Social Worker 1041C0700X LSW0000007127 TN Primary

Addresses

Primary practice location

10805 Kingston Pike Ste 110
Knoxville, TN 37934-3064

Mailing address

162 Harbour Pointe LN
Oak Ridge, TN 37830-1739
Phone (865) 924-4350

Other practice location 1

1851 Crest Rd
Maryville, TN 37804-4304
Phone (865) 983-2212

Other practice location 2

201 W Springdale Ave
Knoxville, TN 37917-5158
Phone (865) 637-9711

Other practice location 3

9724 Kingston Pike Ste 405
Knoxville, TN 37922-6912
Phone (865) 800-8626

Other practice location 4

2202 Award Winning Way Ste 103
Knoxville, TN 37932-1991
Phone (865) 800-8626

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

LicenseStateTypeSpecialty
7127TNMDMental Health Counselor
LSW0000007127TNMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1436832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1124402755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "162 HARBOUR POINTE LN",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378301739",
            "telephone_number": "865-924-4350",
            "fax_number": "865-999-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10805 KINGSTON PIKE STE 110",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379343064",
            "telephone_number": "865-800-8626",
            "fax_number": "865-999-1405"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1851 Crest Rd",
            "address_purpose": "LOCATION",
            "city": "Maryville",
            "state": "TN",
            "postal_code": "378044304",
            "country_code": "US",
            "telephone_number": "865-983-2212",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 W Springdale Ave",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379175158",
            "country_code": "US",
            "telephone_number": "865-637-9711",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9724 Kingston Pike Ste 405",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379226912",
            "country_code": "US",
            "telephone_number": "865-800-8626",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2202 Award Winning Way Ste 103",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379321991",
            "country_code": "US",
            "telephone_number": "865-800-8626",
            "fax_number": "865-999-1405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRESCENZI",
        "first_name": "MATTHEW",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-14",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "7127",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "LSW0000007127",
            "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 Sep 5, 2024; 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.