Healthcare Provider Details

I. General information

NPI: 1598628117
Provider Name (Legal Business Name): CEDAR BRANCH COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 05/24/2026
Certification Date: 05/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 N HENRY ST STE 420A
POST FALLS ID
83854-7665
US

IV. Provider business mailing address

810 N HENRY ST STE 420A
POST FALLS ID
83854-7665
US

V. Phone/Fax

Practice location:
  • Phone: 208-530-6420
  • Fax: 208-643-3321
Mailing address:
  • Phone: 208-530-6420
  • Fax: 208-643-3321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MRS. KERRY D OLSON-PERRIGOUE
Title or Position: OWNER
Credential: LCSW
Phone: 208-220-4754