Provider Demographics
NPI:1215913041
Name:SHAPIRO, JOAN E (LCSW)
Entity type:Individual
Prefix:MS
First Name:JOAN
Middle Name:E
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:177 MAIN ST
Mailing Address - Street 2:STE 207
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-6917
Mailing Address - Country:US
Mailing Address - Phone:631-271-4037
Mailing Address - Fax:
Practice Address - Street 1:177 MAIN ST
Practice Address - Street 2:STE 207
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-6917
Practice Address - Country:US
Practice Address - Phone:631-271-4037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-22
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR235241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN26822OtherMEDICARE
NYN26822OtherMEDICARE