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General NPI Number Information
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NPI Number | 1366032120
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Entity Type | Organization
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Legal Business Name | MEMMS COUNSELING
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Dates
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Enumeration Date | 01/25/2021
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 1015 GIBBINS RD
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City | ARLINGTON
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State | TX
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Zip | 76011-5615
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Country | US
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Telephone | 817-893-0994
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Fax | 866-794-6328
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Provider Business Mailing Address
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Address Line | PO BOX 152315
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City | ARLINGTON
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State | TX
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Zip | 76015-8315
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Country | US
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Telephone | 817-893-0994
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | WALTINA CHAVIS
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Credential | WALTINA CHAVIS, LCDC
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Telephone | 817-893-0994
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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