Provider Demographics
NPI:1124402755
Name:CRESCENZI, MATTHEW (LCSW)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:CRESCENZI
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 HARBOUR POINTE LN
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830-1739
Mailing Address - Country:US
Mailing Address - Phone:865-924-4350
Mailing Address - Fax:865-999-1405
Practice Address - Street 1:2202 AWARD WINNING WAY STE 103
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37932-1991
Practice Address - Country:US
Practice Address - Phone:865-800-8626
Practice Address - Fax:865-999-1405
Is Sole Proprietor?:No
Enumeration Date:2015-07-14
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7127101YM0800X
101YP2500X, 171M00000X
TNLSW00000071271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator