Shon Lorin Shuldberg, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LCSW-28863 Issued in ID

Practice address

1277 E 17TH St
Idaho Falls, ID 83404-6126

Phone

(208) 523-0787

Fax

(208) 523-3175

NPI assigned

Apr 15, 2008

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ashton Memorial, Inc.

  • Psychiatry Physician
  • Idaho Falls, ID
  • NPI 1245670793
  NPD (past)
• Foot & Ankle Specialists of Idaho, P.C.

  • Foot & Ankle Surgery Podiatrist
  • Idaho Falls, ID
  • NPI 1437563699
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529452800000",
    "number": "1326212002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 E 17TH ST",
            "address_2": "STE 4",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046273",
            "telephone_number": "208-523-0787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1277 E 17TH ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046126",
            "telephone_number": "208-523-0787",
            "fax_number": "208-523-3175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULDBERG",
        "first_name": "SHON",
        "middle_name": "LORIN",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-15",
        "last_updated": "2018-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-28863",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LCSW-28863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shopko Stores Operating Co LLC
• Shopko Stores Operating Co. LLC
• Stacy Short, PHARMD
• Shoulder & Knee Center, PA
• Jackson Clay Shubin, D.C.
• Christian T Shull, M.D.
• Braiden R Shumway, DO
• A Shuravloff, DO
• Vance Shurtliff, DPT
• Jan Sibbett, CRNA

• Mental Health Counselor in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Mental Health Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.