Provider Demographics
NPI:1467680843
Name:LINVILLE, JASON (MA)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:LINVILLE
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3014 OZARK CIR
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37415-5104
Mailing Address - Country:US
Mailing Address - Phone:812-360-1776
Mailing Address - Fax:
Practice Address - Street 1:550 S ADAMS ST
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47403-2165
Practice Address - Country:US
Practice Address - Phone:812-333-6324
Practice Address - Fax:812-331-6700
Is Sole Proprietor?:No
Enumeration Date:2009-06-24
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst