Provider Demographics
NPI:1588068175
Name:SHAPIRO, SHELDON S (CAC)
Entity type:Individual
Prefix:MR
First Name:SHELDON
Middle Name:S
Last Name:SHAPIRO
Suffix:
Gender:M
Credentials:CAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6415 LAKE WORTH RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-2910
Mailing Address - Country:US
Mailing Address - Phone:561-327-6977
Mailing Address - Fax:888-463-3113
Practice Address - Street 1:6415 LAKE WORTH RD
Practice Address - Street 2:SUITE 102
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-2910
Practice Address - Country:US
Practice Address - Phone:561-327-6977
Practice Address - Fax:888-463-3113
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-10
Last Update Date:2014-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL004325-2014101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)