=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750240321
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PATHWAY TO HEALING COUNSELING, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/20/2026
-----------------------------------------------------
Last Update Date | 01/20/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 200 N RUFE SNOW DR STE 108D
-----------------------------------------------------
City | KELLER
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76248-4238
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-520-8544
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1809 RIVERCHASE LN
-----------------------------------------------------
City | JUSTIN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76247-6751
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-520-8544
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | COUNSELOR
-----------------------------------------------------
Name | MEGHAN BLAKE
-----------------------------------------------------
Credential | MS, LPC
-----------------------------------------------------
Telephone | 918-520-8544
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0801X
-----------------------------------------------------
Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------