Provider Demographics
NPI:1962120816
Name:MIA SHAPIRO PSYCHOTHERAPY LLC
Entity type:Organization
Organization Name:MIA SHAPIRO PSYCHOTHERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMHC
Authorized Official - Prefix:MS
Authorized Official - First Name:MIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAPIRO
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:339-368-1582
Mailing Address - Street 1:5 HANCOCK AVE
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02420-3412
Mailing Address - Country:US
Mailing Address - Phone:339-368-1582
Mailing Address - Fax:
Practice Address - Street 1:76 BEDFORD ST STE 12
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02420-4640
Practice Address - Country:US
Practice Address - Phone:339-368-1582
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-17
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty