Provider Demographics
NPI:1457141004
Name:SHAPIRO, IVAN (LMSW)
Entity type:Individual
Prefix:MR
First Name:IVAN
Middle Name:
Last Name:SHAPIRO
Suffix:
Gender:
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:282 E 35TH ST APT 6V
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-3931
Mailing Address - Country:US
Mailing Address - Phone:305-333-3026
Mailing Address - Fax:
Practice Address - Street 1:282 E 35TH ST APT 6V
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-3931
Practice Address - Country:US
Practice Address - Phone:305-333-3026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-07
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1041C0700X
NY126866-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical