Provider Demographics
NPI:1043237993
Name:SHAPIRO, MEGHAN C (MA, LPP)
Entity Type:Individual
Prefix:MRS
First Name:MEGHAN
Middle Name:C
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:MA, LPP
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:C
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:2109 EASTWAY DR.
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-1901
Mailing Address - Country:US
Mailing Address - Phone:859-373-0133
Mailing Address - Fax:
Practice Address - Street 1:2109 EASTWAY DR.
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-1901
Practice Address - Country:US
Practice Address - Phone:859-373-0133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-16
Last Update Date:2019-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0852103T00000X
KY0107103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100269620Medicaid