Provider Demographics
NPI:1710311642
Name:REYNOLDS, RHETT MATTHEW (LCSW)
Entity Type:Individual
Prefix:MR
First Name:RHETT
Middle Name:MATTHEW
Last Name:REYNOLDS
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 1:3105 ESSARY DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37918-2409
Mailing Address - Country:US
Mailing Address - Phone:865-688-6160
Mailing Address - Fax:865-687-1190
Practice Address - Street 1:3105 ESSARY DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37918-2409
Practice Address - Country:US
Practice Address - Phone:865-687-8990
Practice Address - Fax:865-687-1190
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-28
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW64161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical