MEDICARE: WELLNESS COUNSELING SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1053077297
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELLNESS COUNSELING SERVICES, LLC

Provider Business Mailing Address
First Line	:	4002 PYRACANTHA DR
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76017-4649
Country	:	US
Telephone Number	:	817-707-7764
Fax Number	:	972-730-9373

Provider Business Practice Location Address
First Line	:	1720 OAK VILLAGE BLVD STE 200B
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76017-7952
Country	:	US
Telephone Number	:	817-505-3901
Fax Number	:	972-730-9373

Authorized Official
Title or Position	:	OWNER
Name	:	MS. DIONE M SIMMONS
Credential	:	LPC
Telephone Number	:	817-707-7764

Provider Enumeration Date	:	11/11/2021
Last Update Date	:	11/11/2021

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Directions to “WELLNESS COUNSELING SERVICES, LLC ” Practice Location

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