Provider Demographics
NPI:1093244527
Name:SHAPIRO, LAURIE (LMHC, CAATP)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:LMHC, CAATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 SALEM ST APT 188
Mailing Address - Street 2:
Mailing Address - City:LYNNFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01940-1591
Mailing Address - Country:US
Mailing Address - Phone:914-806-5986
Mailing Address - Fax:
Practice Address - Street 1:1200 SALEM ST APT 188
Practice Address - Street 2:
Practice Address - City:LYNNFIELD
Practice Address - State:MA
Practice Address - Zip Code:01940-1591
Practice Address - Country:US
Practice Address - Phone:914-806-5986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MA12114101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program