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General NPI Number Information
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NPI Number | 1770295784
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Entity Type | Individual
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Provider Name | PEAR CHERRY MS, LPC
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Gender | Female
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Dates
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Enumeration Date | 12/21/2022
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Last Update Date | 03/28/2024
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Provider Practice Location Address
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Address Line | 1655 W FAIRVIEW AVE STE 209
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City | BOISE
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State | ID
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Zip | 83702-5190
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Country | US
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Telephone | 208-352-0370
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Fax |
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Provider Business Mailing Address
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Address Line | 10000 W TRESTLEWOOD ST
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City | BOISE
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State | ID
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Zip | 83709-6752
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Country | US
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Telephone | 208-819-2622
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC-10271
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License Number State | ID
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