Provider Demographics
NPI:1952973018
Name:WHITSON, DELAYNA LYNNE (LMSW)
Entity Type:Individual
Prefix:
First Name:DELAYNA
Middle Name:LYNNE
Last Name:WHITSON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:629 PROFFITT LN
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37663-3512
Mailing Address - Country:US
Mailing Address - Phone:423-797-1242
Mailing Address - Fax:
Practice Address - Street 1:LAMONT STREET AND VETERANS WAY
Practice Address - Street 2:BUILDING 3
Practice Address - City:MOUNTAIN HOME
Practice Address - State:TN
Practice Address - Zip Code:37684
Practice Address - Country:US
Practice Address - Phone:423-926-1171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-16
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW0000013253104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker