Healthcare Provider Details

I. General information

NPI: 1760391478
Provider Name (Legal Business Name): CHERRY CREEK COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 MORRISON ST
TWIN FALLS ID
83301-5451
US

IV. Provider business mailing address

2032 E 2200 N
TWIN FALLS ID
83301-0625
US

V. Phone/Fax

Practice location:
  • Phone: 208-308-5682
  • Fax:
Mailing address:
  • Phone: 208-308-5682
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: KELSIE ROBINSON
Title or Position: OWNER
Credential: LCPC
Phone: 208-308-5682