Provider Demographics
NPI:1306457635
Name:SHAPIRO, ALYSSA ROBIN (PSYD)
Entity type:Individual
Prefix:DR
First Name:ALYSSA
Middle Name:ROBIN
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 WALNUT ST APT 401
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-5408
Mailing Address - Country:US
Mailing Address - Phone:516-659-4921
Mailing Address - Fax:
Practice Address - Street 1:255 S 17TH ST STE 1106
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-6212
Practice Address - Country:US
Practice Address - Phone:215-564-9900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-11
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS020484103T00000X, 103TC0700X
NY104841-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No104100000XBehavioral Health & Social Service ProvidersSocial Worker