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Shane Clubb, M.A., L.C.P.C

NPI 1871554584 · on the registry since 2006

Practice

Address: 39 E State Ave
Meridian, ID 83642
Phone: (208) 994-3599
Fax: (208) 473-2206
Organisation at this address: State Avenue Offices
Lisa Deluca Counseling, Pllc
Weightless Minds Counseling, Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 5

Registry record

Primary taxonomy: Mental Health Counselor
101YM0800X
Licence states on file: ID
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2012-12-10

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho