Provider Demographics
NPI:1770295784
Name:CHERRY, PEAR (MS, LPC)
Entity type:Individual
Prefix:MS
First Name:PEAR
Middle Name:
Last Name:CHERRY
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10000 W TRESTLEWOOD ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83709-6752
Mailing Address - Country:US
Mailing Address - Phone:208-819-2622
Mailing Address - Fax:
Practice Address - Street 1:1655 W FAIRVIEW AVE STE 209
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-5190
Practice Address - Country:US
Practice Address - Phone:208-352-0370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-21
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
IDLPC-10271101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health