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

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
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Practice location Address checks out

2007 E Quail Run Rd
Emmett, ID 83617-5059
Phone: (208) 365-5445
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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 LPC-6270 (ID)

Record details

NPI number1336697366
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 19, 2016
Last updated in NPPESSeptember 19, 2016

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