Provider Demographics
NPI:1417945858
Name:SHAPIRO, LOREN (PHD)
Entity type:Individual
Prefix:DR
First Name:LOREN
Middle Name:
Last Name:SHAPIRO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12573 CHILLICOTHE RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44026-2536
Mailing Address - Country:US
Mailing Address - Phone:440-729-3645
Mailing Address - Fax:440-729-3645
Practice Address - Street 1:12573 CHILLICOTHE RD
Practice Address - Street 2:
Practice Address - City:CHESTERLAND
Practice Address - State:OH
Practice Address - Zip Code:44026-2536
Practice Address - Country:US
Practice Address - Phone:440-729-3645
Practice Address - Fax:440-729-3645
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-10
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3327103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHLOREN SHAPIRO, PH.D.Medicare ID - Type UnspecifiedSHCP05601