Provider Demographics
NPI:1194999581
Name:ADINA SHAPIRO, LCSW
Entity type:Organization
Organization Name:ADINA SHAPIRO, LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:
Authorized Official - First Name:ADINA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:SHAPIRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-761-3939
Mailing Address - Street 1:1495 CHAIN BRIDGE RD STE 202
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-5727
Mailing Address - Country:US
Mailing Address - Phone:703-761-3939
Mailing Address - Fax:571-633-9798
Practice Address - Street 1:1495 CHAIN BRIDGE RD STE 202
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-5727
Practice Address - Country:US
Practice Address - Phone:703-761-3939
Practice Address - Fax:571-633-9798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-16
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040043551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCG01013Medicare PIN