Healthcare Provider Details

I. General information

NPI: 1669043709
Provider Name (Legal Business Name): CHENITE TYUS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2021
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3909 COVINGTON PIKE
MEMPHIS TN
38135-2281
US

IV. Provider business mailing address

1700 COVEMEADOW DR
ARLINGTON TX
76012-5407
US

V. Phone/Fax

Practice location:
  • Phone: 731-394-1145
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number8630
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number85726
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: