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CLEARWATER PSYCHIATRY PLLC

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Company Details

Name: CLEARWATER PSYCHIATRY PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 26 Apr 2021 (4 years ago)
Financial Date End: 30 Apr 2026
Entity Number: 4256289
Place of Formation: IDAHO
File Number: 760402
ZIP code: 83616
County: Ada County
Principal Address: 272 W RIVER MEADOW DR EAGLE, ID 83616
Mailing Address: CINDY SEVIERI STE 101 413 N ALLUMBAUGH ST BOISE, ID 83704-9219

Agent

Name Role Address
DAVID THOMPSON Agent 272 W RIVER MEADOW DR, EAGLE, ID 83616

Member

Name Role Address Appointed On
DAVID THOMPSON M.D. Member 272 W RIVER MEADOW DR, EAGLE, ID 83616 2022-03-30

U.S. Small Business Administration Profile

The U.S. Small Business Administration (SBA) helps Americans start, grow, and build resilient businesses.

Note: SBA was created in 1953 as an independent agency of the federal government to aid, counsel, assist and protect the interests of small business concerns; preserve free competitive enterprise; and maintain and strengthen the overall economy of our nation. SBA reviews Congressional and testifies on behalf of small businesses. It assesses the impact of regulatory burden on small businesses.

Phone Number:
Contact Person:
ROBIN CALDWELL
User ID:
P3351667

Unique Entity ID

A UEI is a government-provided number, like a tax ID number, that’s used to identify businesses eligible for federal grants, awards and contracts.

Note: In April 2022, the federal government replaced its old identifier of choice, the Data Universal Numbering System (DUNS) number, with a government-issued UEI. Now all the federal government’s Integrated Award Environment systems use UEI numbers instead of DUNS numbers. So any entity doing business with the federal government must register for a UEI.

Unique Entity ID:
SXLFZCRYAK63
CAGE Code:
0PQW7
UEI Expiration Date:
2025-12-10

Business Information

Activation Date:
2024-12-12
Initial Registration Date:
2024-12-10

National Provider Identifier

NPI Number:
1487318960
Certification Date:
2021-10-29

Authorized Person:

Name:
CHERI PETERSON
Role:
CREDENTIALING SPECIALIST
Phone:

Taxonomy:

Selected Taxonomy:
2084P0800X - Psychiatry Physician
Is Primary:
Yes

Contacts:

Fax:
2083239604

Filing

Filing Name Filing Number Filing date
Annual Report 0006157955 2025-03-12
Annual Report 0005634948 2024-03-05
Annual Report 0005135134 2023-03-03
Annual Report 0004676379 2022-03-30
Statement of Change of Business Mailing Address 0004453936 2021-10-14

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Date of last update: 19 May 2025

Sources: Idaho Secretary of State