Provider Demographics
NPI:1811703788
Name:SHANTI PATH BEHAVIORAL HEALTH PLLC
Entity type:Organization
Organization Name:SHANTI PATH BEHAVIORAL HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHANTI
Authorized Official - Middle Name:P
Authorized Official - Last Name:ARADHYULA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:512-240-2971
Mailing Address - Street 1:12856 N HWY 183, STE B #2026
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750
Mailing Address - Country:US
Mailing Address - Phone:512-666-0516
Mailing Address - Fax:
Practice Address - Street 1:12856 N HWY 183, STE B
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750
Practice Address - Country:US
Practice Address - Phone:512-666-0516
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-05
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health