Mr Shon Lorin Shuldberg, LCSW is a medicare enrolled "Counselor - Mental Health" provider in Idaho Falls, Idaho. His current practice location is
1277 E 17th St, Idaho Falls, Idaho. You can reach out to his office (for appointments etc.) via phone at
(208) 523-0787.
Mr Shon Lorin Shuldberg is licensed to practice in Idaho (license number LCSW-28863) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1326212002.
Healthcare Provider's Profile
| Full Name | Mr Shon Lorin Shuldberg |
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| Gender | Male |
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| Speciality | Counselor - Mental Health |
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| Location | 1277 E 17th St, Idaho Falls, Idaho |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1326212002
- Provider Enumeration Date: 04/15/2008
- Last Update Date: 06/20/2018
Medicare PECOS Information:
- PECOS PAC ID: 4486724721
- Enrollment ID: I20080529000560
Medical Identifiers
Medical identifiers for Mr Shon Lorin Shuldberg such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1326212002 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 1041C0700X | Social Worker - Clinical | LCSW-28863 (Idaho) | Secondary |
| 101YM0800X | Counselor - Mental Health | LCSW-28863 (Idaho) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Shon Lorin Shuldberg allows following entities to bill medicare on his behalf.
| Entity Name | Ashton Memorial Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1003907163
PECOS PAC ID: 7719898873
Enrollment ID: O20080529000529 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Shon Lorin Shuldberg is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Shon Lorin Shuldberg, LCSW
1301 E 17th St, Ste 4,
Idaho Falls, ID 83404-6273
Ph: (208) 523-0787 | Mr Shon Lorin Shuldberg, LCSW
1277 E 17th St,
Idaho Falls, ID 83404-6126
Ph: (208) 523-0787 |
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