Provider Demographics
NPI:1235586967
Name:A GUIDING PATH, LLC
Entity Type:Organization
Organization Name:A GUIDING PATH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:BRENDEN
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC, LCPC
Authorized Official - Phone:406-552-3587
Mailing Address - Street 1:6315 LONE MOOSE CT
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:MT
Mailing Address - Zip Code:59833-6005
Mailing Address - Country:US
Mailing Address - Phone:505-977-5376
Mailing Address - Fax:
Practice Address - Street 1:2875 TINA AVE STE 106
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59808-1582
Practice Address - Country:US
Practice Address - Phone:406-552-3587
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-23
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0181451101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0686766Medicaid
NM42171547Medicaid