MEDICARE: CHOOSE YOUR PATH COUNSELING SERVICE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QM0850X	Adult Mental Health Clinic/Center
2	251B00000X	Case Management Agency
3	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center
4	261QM0855X	Adolescent and Children Mental Health Clinic/Center
5	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1689286643
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHOOSE YOUR PATH COUNSELING SERVICE, LLC

Provider Business Mailing Address
First Line	:	1585 BATTLE RIDGE RD
Second Line	:
City	:	KOOSKIA
State	:	ID
Zip	:	83539-5092
Country	:	US
Telephone Number	:	208-553-8137
Fax Number	:	208-298-3851

Provider Business Practice Location Address
First Line	:	158 E MAIN ST STE 4
Second Line	:
City	:	GRANGEVILLE
State	:	ID
Zip	:	83530-2283
Country	:	US
Telephone Number	:	208-553-8137
Fax Number	:	208-298-3851

Authorized Official
Title or Position	:	OWNER/LCSW
Name	:	HEATHER MARIE BUTTS
Credential	:
Telephone Number	:	208-553-8137

Provider Enumeration Date	:	08/20/2020
Last Update Date	:	05/11/2026

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