OrganizationActive
City Creek Counseling, LLC
NPI 1649756057 · Mental Health Clinic/Center (Including Community Mental Health Center) · Pocatello, ID
Provider details
- NPI number
- 1649756057
- Entity type
- Organization
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center)Ambulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Tandice Peterson, Co-Owner(208) 339-0909
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(68/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1219 Yellowstone Ave Ste D
Pocatello, ID 83201-4368
Phone: (208) 339-0909
Fax: (208) 339-0909
Street-level locationGet directions
Mailing address
1219 Yellowstone Ave Ste D
Pocatello, ID 83201-4368
Registry dates
- Enumerated
- 2018-07-18
- Last updated
- 2018-07-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.