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

Shane Weideman

Individual provider Mental Health Counselor · NPI 1336697366

Shane Weideman is a Mental Health Counselor in Emmett, Idaho. Qualified in 2016, 10 years ago. Practices with Emmett Counseling and Psychiatric Services LLC, a 4-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
10
Licensed in
ID
In the registry since
2016

Practice location Address checks out

2007 E Quail Run Rd
Emmett, ID 83617-5059
Phone: (208) 365-5445
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence LPC-6270 (ID)

Record details

NPI number1336697366
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 19, 2016
Last updated in NPPESSeptember 19, 2016
Mailing address2305 Valley View Dr, Weiser, ID 83672-1245

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Emmett Counseling And Psychiatric Services Llc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Emmett