person
Mr. Shane M Clubb, MA,LCPC
Mental Health Counselor in Meridian, Idaho
NPI 1871554584

Shane M Clubb is a Mental Health Counselor based in Meridian, ID and is specialized in Mental Health. Shane M Clubb practices in Meridian, ID and has the professional credentials of MA,LCPC. The NPI Number for Shane M Clubb is 1871554584 and holds a License No. LCPC-3989 (Idaho).

The current practice location address for Shane M Clubb is 39 E State Ave, Meridian, ID and can be reached out via phone at 208-994-3599 and via fax at 208-473-2206.

Location: 39 E State Ave, Meridian, ID, 83642-2342
person
Provider Profile Details
NPI Number
1871554584
Provider Name
Shane M Clubb
Credential
MA,LCPC
Provider Entity Type
Individual
Gender
Male
Address
39 E State Ave, Meridian, ID, 83642-2342
Phone Number
208-994-3599
Fax Number
208-473-2206
Provider Enumeration Date
03/31/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
39 E State Ave
City
State
Zip
83642-2342
Phone Number
208-994-3599
Fax Number
208-473-2206
person
Provider Business Mailing Address Details
Address
39 E State Ave
City
State
Zip
83642-2342
Phone Number
208-994-3599
Fax Number
208-473-2206
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
LCPC-3989 (Idaho)
Definition
Definition to come...
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