Provider Demographics
NPI:1306638218
Name:SHAPIRO, MATTHEW TODD (LMFT)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:TODD
Last Name:SHAPIRO
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2115 BEACHWOOD TER
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90068-3405
Mailing Address - Country:US
Mailing Address - Phone:646-573-5820
Mailing Address - Fax:
Practice Address - Street 1:2115 BEACHWOOD TER
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90068-3405
Practice Address - Country:US
Practice Address - Phone:646-573-5820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA155220106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist