MEDICARE: BODHI COUNSELING AND CONSULTING PLLC

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598422537
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BODHI COUNSELING AND CONSULTING PLLC

Provider Business Mailing Address
First Line	:	1717 W 34TH ST STE 600-185
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77018-6256
Country	:	US
Telephone Number	:	713-909-4932
Fax Number	:

Provider Business Practice Location Address
First Line	:	1717 W 34TH ST STE 600-185
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77018-6256
Country	:	US
Telephone Number	:	713-909-4932
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MARIA LOURDES ORTIZ
Credential	:	LPC
Telephone Number	:	713-909-4932

Provider Enumeration Date	:	11/24/2021
Last Update Date	:	08/08/2023

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