Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Shane M Clubb, MA, LCPC

Individual provider Mental Health Counselor · NPI 1871554584

Mr. Shane M Clubb, MA, LCPC is a Mental Health Counselor in Meridian, Idaho. Licensed in Idaho. Registered with an NPI since 2006.

Licensed in
ID
In the registry since
2006
What do these letters mean?
MA — Master of Arts
A graduate arts degree.
LCPC — Licensed Clinical Professional Counselor
A licensed clinical counsellor.

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Practice location Address checks out

39 E State Ave
Meridian, ID 83642-2342
Phone: (208) 994-3599
Fax: (208) 473-2206
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence LCPC-3989 (ID)

Record details

NPI number1871554584
Entity typeIndividual (Type 1)
GenderMale
Credentials MA , LCPC
Sole proprietorNo
NPI enumeratedMarch 31, 2006
Last updated in NPPESDecember 10, 2012

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