Provider Demographics
NPI:1366917932
Name:SHAPIRO, KATHERINE E
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:E
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 TERRENTS CT
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-8533
Mailing Address - Country:US
Mailing Address - Phone:240-723-5371
Mailing Address - Fax:
Practice Address - Street 1:8727 COMMERCE PARK PL STE L
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-3132
Practice Address - Country:US
Practice Address - Phone:317-887-3290
Practice Address - Fax:317-887-6894
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-09
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34007253A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical