Provider Demographics
NPI:1104420538
Name:SHPIGEL, DANIELLE MIRI (PHD)
Entity type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:MIRI
Last Name:SHPIGEL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 WILSON BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201-3324
Mailing Address - Country:US
Mailing Address - Phone:703-539-5006
Mailing Address - Fax:
Practice Address - Street 1:2200 WILSON BLVD STE 210
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22201-3324
Practice Address - Country:US
Practice Address - Phone:703-539-5006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-25
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023991103G00000X, 103T00000X, 103TC0700X
DCPSY1001675103G00000X, 103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical