MEDICARE: PAHTIA COUNSELING CENTER

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1528943172
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAHTIA COUNSELING CENTER

Provider Business Mailing Address
First Line	:	645 FM 967 STE 102
Second Line	:
City	:	BUDA
State	:	TX
Zip	:	78610-4747
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	645 FM 967 STE 102
Second Line	:
City	:	BUDA
State	:	TX
Zip	:	78610-4747
Country	:	US
Telephone Number	:	469-232-7716
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	SIDUK ARROYO-BOULTER
Credential	:	LPC
Telephone Number	:	469-232-7716

Provider Enumeration Date	:	08/11/2025
Last Update Date	:	08/11/2025

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Directions to “PAHTIA COUNSELING CENTER ” Practice Location

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