Provider Demographics
NPI:1043593338
Name:SHAPIRO, MONIQUE COUTEAU (LCSW-C)
Entity Type:Individual
Prefix:
First Name:MONIQUE
Middle Name:COUTEAU
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 LANGLEY RD N
Mailing Address - Street 2:SUITE A
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21060-6531
Mailing Address - Country:US
Mailing Address - Phone:410-222-6785
Mailing Address - Fax:410-222-6888
Practice Address - Street 1:122 LANGLEY RD N
Practice Address - Street 2:SUITE A
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21060-6531
Practice Address - Country:US
Practice Address - Phone:410-222-6785
Practice Address - Fax:410-222-6888
Is Sole Proprietor?:No
Enumeration Date:2011-09-22
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15027104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker