Healthcare Provider Details

I. General information

NPI: 1750236444
Provider Name (Legal Business Name): CHERRY VALLEY COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11904 KELLY RD NE
DUVALL WA
98019-6509
US

IV. Provider business mailing address

11904 KELLY RD NE
DUVALL WA
98019-6509
US

V. Phone/Fax

Practice location:
  • Phone: 425-773-4918
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: RACHEL HEIDENREICH LAZAR
Title or Position: CLINICAL SOCIAL WORKER
Credential: MSW, LICSW
Phone: 425-773-4918