REVITALIZE MINDS COUNSELING
NPI 1467188664
Social Worker - Clinical in West Memphis, AR

Q: What is Revitalize Minds Counseling's NPI number?

The NPI number for Revitalize Minds Counseling is 1467188664. It was assigned to this organization in the NPPES registry on July 29, 2022.

Q: What is Revitalize Minds Counseling's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Active since July 29, 2022

312 N MISSOURI ST STE 1, WEST MEMPHIS, AR 72301(870) 796-8997(870) 796-8998 Get Directions Write a Review

NPPES record last updated: January 16, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 16, 2023, Jul 29, 2022 (2 updates tracked since 2022).

On this page

About Revitalize Minds Counseling NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

REVITALIZE MINDS COUNSELING (NPI 1467188664) is a healthcare organization registered as a clinical in West Memphis, Arkansas and active in the NPI registry since July 2022. The organization maintains a secondary practice location in Marion and lists Tangella Michelle Foreman, Therapist, as its authorized official.

NPPES Registry Identity

NPI1467188664

Entity TypeOrganization

Primary Taxonomy1041C0700X

Legal Business NameREVITALIZE MINDS COUNSELING

Location Address312 N MISSOURI ST STE 1West Memphis, AR 72301-3186

Mailing Address312 N Missouri StWest Memphis, AR 72301-3142 · (870) 796-8997 · Fax (870) 796-8998

Phone(870) 796-8997

Fax(870) 796-8998

Organization SubpartNo

Authorized OfficialTangella Michelle ForemanTherapist · (870) 926-7344

Enumeration DateJuly 29, 2022

Last NPPES UpdateJanuary 16, 20232 updates tracked since enumeration

NPPES CertifiedAugust 5, 2022

✔ NPI 1467188664 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

312 N MISSOURI ST STE 1, West Memphis, AR 72301

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Secondary Practice Location 1

Location 1927 Bayou Vista DrMarion, AR 72364-5076 · Phone (870) 926-7344

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Revitalize Minds Counseling is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Revitalize Minds Counseling, which bills Medicare for the services this clinician delivers.

Clinician (1)

Tangella Foreman, LCSW

Clinical Social Worker

NPI 1609164730

4001 COMMERCIAL CENTER DR STE 2
Marion, AR 72364

(870) 732-7920

✔ PECOS✔ Accepts Medicare3.5 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Revitalize Minds Counseling's NPI number?

The NPI number for Revitalize Minds Counseling is 1467188664. It was assigned to this organization in the NPPES registry on July 29, 2022.

Where is Revitalize Minds Counseling located?

Revitalize Minds Counseling is located at 312 N Missouri St Ste 1, West Memphis, AR 72301. The listed phone number is (870) 796-8997.

What is Revitalize Minds Counseling's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Revitalize Minds Counseling enrolled in Medicare?

Yes. Revitalize Minds Counseling is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Revitalize Minds Counseling?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Social Worker) reassigns their Medicare billing to Revitalize Minds Counseling. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Revitalize Minds Counseling was last updated on January 16, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.