Shane M Clubb is a Mental Health in Meridian, Idaho. Shane M Clubb practices all healthcare services and medical treatments related to Mental Health. The NPI Number for Shane M Clubb is 1871554584. The last update date is 2012-12-10.
Shane M Clubb's current location address is 39 E State Ave, Meridian, Idaho. You can contact this provider via phone number 2089943599 and fax number 2084732206. The mailing address for Shane M Clubb is 39 E State Ave, Meridian, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Shane M Clubb |
|---|---|
| Address | 39 E State Ave, Meridian, Idaho |
| Phone Number | 2089943599 |
| Fax Number | 2084732206 |
| Sole Proprietor | N |
| Credentials | M.A., L.C. |
NPI Number Detail
| NPI Number | 1871554584 |
|---|---|
| Provider Enumeration Date | 2006-03-31 |
| Last Updated Date | 2012-12-10 |
Provider Mailing Address Detail
| Address | 39 E State Ave |
|---|---|
| City | Meridian |
| State | Idaho (ID) |
| Post Code | 836422342 |
| Phone Number | 2089943599 |
| Fax Number | 2084732206 |
Provider's Primary Taxonomy Detail
| Speciality | Mental Health |
|---|---|
| Taxonomy | 101Ym0800X |
| Licence No | LCPC-3989 |
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Definition: A counselor who helps people manage conditions like depression, anxiety, grief, relationship issues, and more. |
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What is the unique 10-digit identification code issued to Shane M Clubb by the Centers for Medicare & Medicaid Services?
The Shane M Clubb has been assigned the NPI (National Provider Identifier) 1871554584 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Can you provide the Shane M Clubb's physical address?
The Shane M Clubb is physically located at 39 E State Ave, in the city of Meridian, ID, with the postal code 836422342.
What is Shane M Clubb's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Shane M Clubb is Mental Health, and the taxonomy code that classifies this field of practice is 101Ym0800X.
When did Shane M Clubb receive its 1871554584 assignment?
The Shane M Clubb was assigned its 1871554584 on 2006-03-31, which is the date when this unique identifier was issued to the organization.
As of what date were the Shane M Clubb's details last updated?
The information pertaining to the Shane M Clubb, including its address, specialty, and other details, was most recently updated on 2012-12-10.
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