Individual provider Active NPI

Sharletta Wentworth, LPC-MHSP

  • Mental Health Counselor
  • Knoxville, TN
National Provider Identifier
1346638889
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
4064 Issued in TN
Practice address
5645 Merchants Center Blvd
Knoxville, TN 37912-3470
Phone
(865) 637-9711
NPI assigned
Jan 7, 2015
Last updated
Apr 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 4064 TN Primary
Professional Counselor 101YP2500X 4064 TN

Addresses

Primary practice location

5645 Merchants Center Blvd
Knoxville, TN 37912-3470

Mailing address

200 Tech Center Dr
Knoxville, TN 37912-2747
Phone (865) 637-9711

Other practice location 1

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

Other practice location 2

2455 Sutherland Ave
Knoxville, TN 37919
Phone (865) 544-5000 ext. 5041

Other identifiers 1

IdentifierTypeStateIssuer
Q031260MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231218001351 TN Practitioner - Mental Health Counselor 7911356852 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4064TNMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Helen Ross McNabb Center CurrentSince Mar 7, 2021 Accepting new patients
Helen Ross McNabb Center CurrentSince Jan 1, 2023 Accepting new patients

Locations

200 Tech Center Dr
Knoxville, TN 37912
Phone (865) 329-9124

201 W Springdale Ave
Knoxville, TN 37917
Phone (865) 329-9173

2455 Sutherland Ave
Knoxville, TN 37919
Phone (865) 544-5000

5645 Merchants Center Blvd
Knoxville, TN 37912
Phone (865) 257-9982

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": "1420588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1346638889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 TECH CENTER DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379122747",
            "telephone_number": "865-637-9711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5645 MERCHANTS CENTER BLVD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379123470",
            "telephone_number": "865-637-9711"
        }
    ],
    "practiceLocations": [
        {
            "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": "2455 Sutherland Ave",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "37919",
            "country_code": "US",
            "telephone_number": "865-544-5000 x5041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WENTWORTH",
        "first_name": "SHARLETTA",
        "credential": "LPC-MHSP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-07",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "4064",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "4064",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q031260",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.