MEDICARE: THE HEALING PATH, LLC

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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1497553796
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE HEALING PATH, LLC

Provider Business Mailing Address
First Line	:	PO BOX 103
Second Line	:
City	:	COTTONWOOD
State	:	ID
Zip	:	83522-0103
Country	:	US
Telephone Number	:	208-921-3920
Fax Number	:

Provider Business Practice Location Address
First Line	:	404 MAIN ST STE A
Second Line	:
City	:	COTTONWOOD
State	:	ID
Zip	:	83522-5270
Country	:	US
Telephone Number	:	208-921-3920
Fax Number	:

Authorized Official
Title or Position	:	OWNER/MANAGER
Name	:	HOLLY GRAHAM
Credential	:	LCPC
Telephone Number	:	208-921-3920

Provider Enumeration Date	:	03/04/2025
Last Update Date	:	02/05/2026

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Directions to “THE HEALING PATH, LLC ” Practice Location

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