MEDICARE: CEDAR BRANCH COUNSELING, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1598628117
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CEDAR BRANCH COUNSELING, LLC

Provider Business Mailing Address
First Line	:	3895 W CLIFFSIDE LN
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99224-6202
Country	:	US
Telephone Number	:	208-220-4754
Fax Number	:

Provider Business Practice Location Address
First Line	:	3895 W CLIFFSIDE LN
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99224-6202
Country	:	US
Telephone Number	:	208-220-4754
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. KERRY D OLSON-PERRIGOUE
Credential	:	LCSW
Telephone Number	:	208-220-4754

Provider Enumeration Date	:	12/09/2025
Last Update Date	:	12/09/2025

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