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COPPER CREEK COUNSELING CENTER LLC

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Company Details

Name: COPPER CREEK COUNSELING CENTER LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 04 Sep 2007 (18 years ago)
Financial Date End: 30 Sep 2025
Date dissolved: 06 Dec 2024
Entity Number: 209805
Place of Formation: IDAHO
File Number: 209805
ZIP code: 83642
County: Ada County
Mailing Address: STE 100 2971 E COPPER POINT DR MERIDIAN, ID 83642-9276

Agent

Name Role Address
LAURA CROMWELL Agent 2971 E COPPER POINT DR STE 100, MERIDIAN, ID 83642

Manager

Name Role Address Appointed On
Copper Creek Counseling LLC Manager 2971 E. COPPER POINT DRIVE, MERIDIAN, ID 83642 2020-08-20

National Provider Identifier

NPI Number:
1699382598
Certification Date:
2020-09-25

Authorized Person:

Name:
MRS. LAURA ANN CROMWELL
Role:
MANAGER/OWNER
Phone:

Taxonomy:

Selected Taxonomy:
101YM0800X - Mental Health Counselor
Is Primary:
Yes

Contacts:

Fax:
2083765690

Filing

Filing Name Filing Number Filing date
Application for Reinstatement 0006111791 2025-02-18
Dissolution/Revocation - Administrative 0006013422 2024-12-06
Annual Report 0005477899 2023-11-14
Annual Report 0004866223 2022-08-21
Annual Report 0004387624 2021-08-18

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Date of last update: 29 May 2025

Sources: Idaho Secretary of State