Provider Demographics
NPI:1003986308
Name:SHAPIRO, ADINA Y (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ADINA
Middle Name:Y
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1495 CHAIN BRIDGE RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:MCLEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-5727
Mailing Address - Country:US
Mailing Address - Phone:703-761-3939
Mailing Address - Fax:571-633-9798
Practice Address - Street 1:1495 CHAIN BRIDGE RD
Practice Address - Street 2:SUITE 202
Practice Address - City:MCLEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-5727
Practice Address - Country:US
Practice Address - Phone:703-761-3939
Practice Address - Fax:571-633-9798
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040043551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC00B388A13Medicare PIN