Provider Demographics
NPI:1922582154
Name:LINVILLE, TIERNEY PAIGE (LPC-TA)
Entity Type:Individual
Prefix:
First Name:TIERNEY
Middle Name:PAIGE
Last Name:LINVILLE
Suffix:
Gender:F
Credentials:LPC-TA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4224 SHUFFIELD DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-7211
Mailing Address - Country:US
Mailing Address - Phone:501-355-6848
Mailing Address - Fax:501-526-5296
Practice Address - Street 1:4224 SHUFFIELD DR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-7211
Practice Address - Country:US
Practice Address - Phone:501-355-6848
Practice Address - Fax:501-526-5296
Is Sole Proprietor?:No
Enumeration Date:2018-09-24
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP2207012101YP2500X, 101YM0800X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator