Provider Demographics
NPI:1518729029
Name:CEDAR SAGE COUNSELING PLLC
Entity Type:Organization
Organization Name:CEDAR SAGE COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:208-284-7709
Mailing Address - Street 1:1478 WINDSONG
Mailing Address - Street 2:
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83201-2346
Mailing Address - Country:US
Mailing Address - Phone:208-284-7709
Mailing Address - Fax:
Practice Address - Street 1:1478 WINDSONG
Practice Address - Street 2:
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83201-2346
Practice Address - Country:US
Practice Address - Phone:208-284-7709
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-29
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty