Active NPI
Frank E Shull, MED LCPC
- Professional Counselor
- Lewiston, ID
National Provider Identifier
1336138106
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LCPC3102
- Practice address
- 1630 23Rd Ave
BLDG 301
Lewiston, ID 83501 - Phone
- (208) 790-3083
- Fax
- (208) 798-7177
- NPI assigned
- Oct 14, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LH00004257 | WA | |
| Professional Counselor | 101YP2500X | LCPC3102 | ID | Primary |
Addresses
Primary practice location
1630 23Rd Ave
BLDG 301
Lewiston, ID 83501
Mailing address
317 15TH Ave
Lewiston, ID 83501
Phone (208) 790-3083
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 05191 | Other | ID | BLUE CROSS OF ID |
| 000010147555 | Other | ID | REGENCE BLUE SHIELD OF ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LH00004257 | WA | MD | Mental Health Counselor |
| LCPC3102 | ID | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bridgeway Counseling Center, LC | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinical Social Worker
- Lewiston, ID
- NPI 1750396636
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129248000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1336138106",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "317 15TH AVE",
"city": "LEWISTON",
"state": "ID",
"postal_code": "83501",
"telephone_number": "208-790-3083",
"fax_number": "208-798-7177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1630 23RD AVE",
"address_2": "BLDG 301",
"city": "LEWISTON",
"state": "ID",
"postal_code": "83501",
"telephone_number": "208-790-3083",
"fax_number": "208-798-7177"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHULL",
"first_name": "FRANK",
"middle_name": "E",
"credential": "MED LCPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-14",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "LH00004257",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "ID",
"license": "LCPC3102",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS OF ID",
"identifier": "05191",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUE SHIELD OF ID",
"identifier": "000010147555",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lewiston, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.