Healthcare Provider Details

I. General information

NPI: 1063322378
Provider Name (Legal Business Name): EDILEYNE V LINVILLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EDILEYNE V DELGADO LPC/ MHSP

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1145 VOLUNTEER PKWY
BRISTOL TN
37620-4652
US

IV. Provider business mailing address

1167 SPRATLIN PARK DR
GRAY TN
37615-6205
US

V. Phone/Fax

Practice location:
  • Phone: 423-989-4500
  • Fax: 423-989-4582
Mailing address:
  • Phone: 423-467-3600
  • Fax: 423-467-3644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number8839
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: