Individual provider Active NPI

Tony Weaver, LPC- MHSP

  • Mental Health Counselor
  • Knoxville, TN
National Provider Identifier
1740632850
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
4841 Issued in TN
Practice address
3712 Middlebrook Pike
Knoxville, TN 37921-6503
Phone
(865) 444-2333
NPI assigned
Jul 13, 2016
Last updated
Apr 24, 2024By the provider in NPPES
Sex
Male
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 4841 TN Primary
Professional Counselor 101YP2500X 4841 TN

Addresses

Primary practice location

3712 Middlebrook Pike
Knoxville, TN 37921-6503

Mailing address

200 Tech Center Dr
Knoxville, TN 37912-2747

Other practice location 1

215 Center Park Dr Ste 200
Knoxville, TN 37922-2182
Phone (865) 978-6200

Other practice location 2

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

Other identifiers 1

IdentifierTypeStateIssuer
Q056346MedicaidTN

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
I20231218001609 TN Practitioner - Mental Health Counselor 8123477072 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4841TNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Helen Ross McNabb Center CurrentSince Mar 7, 2021 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

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": "1468368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1740632850",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3712 MIDDLEBROOK PIKE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379216503",
            "telephone_number": "865-444-2333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "215 Center Park Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379222182",
            "country_code": "US",
            "telephone_number": "865-978-6200",
            "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"
        }
    ],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "TONY",
        "name_prefix": "Mr.",
        "credential": "LPC- MHSP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-13",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "4841",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "4841",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q056346",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.