Healthcare Provider Details
I. General information
NPI: 1245887215
Provider Name (Legal Business Name): BRENNAN JOSEPH DOWNEY LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/23/2019
Last Update Date: 04/10/2023
Certification Date: 04/10/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
538 W 5TH AVE
KNOXVILLE TN
37917-7109
US
IV. Provider business mailing address
1923 SULPHUR SPRINGS RD
MORRISTOWN TN
37813-5654
US
V. Phone/Fax
- Phone: 865-525-2104
- Fax: 865-525-2212
- Phone: 423-317-9344
- Fax: 423-714-2355
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 104100000X |
| Taxonomy | Social Worker |
| License Number | 12957 |
| License Number State | TN |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | LSW8496 |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: