MEDICARE: BELLWETHER COUNSELING, PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	1041C0700X	Clinical Social Worker
3	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1164193736
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BELLWETHER COUNSELING, PLLC

Provider Business Mailing Address
First Line	:	2314 RAINTREE PATH
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78664-7777
Country	:	US
Telephone Number	:	151-263-6862
Fax Number	:

Provider Business Practice Location Address
First Line	:	1311 CHISHOLM TRAIL RD STE 402
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78681-2970
Country	:	US
Telephone Number	:	512-650-8085
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	DR. ASHLEY BLU STAATS
Credential	:	PHD
Telephone Number	:	512-636-8629

Provider Enumeration Date	:	09/23/2021
Last Update Date	:	06/25/2024

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