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CITY CREEK COUNSELING, LLC

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Company Details

Name: CITY CREEK COUNSELING, LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 11 Jun 2018 (7 years ago)
Financial Date End: 30 Jun 2026
Entity Number: 613270
Place of Formation: IDAHO
File Number: 613270
ZIP code: 83201
County: Bannock County
Principal Address: 1219 YELLOWSTONE SUITE D POCATELLO, ID 83201
Mailing Address: STE D 1219 YELLOWSTONE AVE POCATELLO, ID 83201-4368

Agent

Name Role Address
KATIE MULALLEY Agent 1219 YELLOWSTONE AVENUE, SUITE D, POCATELLO, ID 83201

Member

Name Role Address Appointed On
Katie Mulalley Member 1219 YELLOWSTONE AVENUE, POCATELLO, ID 83201 2021-06-13

National Provider Identifier

NPI Number:
1649756057

Authorized Person:

Name:
TANDICE CHAELEE PETERSON
Role:
CO-OWNER
Phone:

Taxonomy:

Selected Taxonomy:
261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center)
Is Primary:
Yes

Contacts:

Fax:
2083390909

Filing

Filing Name Filing Number Filing date
Annual Report 0006231775 2025-05-04
Annual Report 0005743592 2024-05-21
Annual Report 0005231743 2023-05-07
Annual Report 0004740529 2022-05-09
Annual Report 0004313987 2021-06-13

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Date of last update: 05 Jul 2025

Sources: Idaho Secretary of State