Provider Demographics
NPI:1093872186
Name:SHAPIRO, MARSHA N (ACSW, LCSW, BCD)
Entity Type:Individual
Prefix:MS
First Name:MARSHA
Middle Name:N
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:ACSW, LCSW, BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1626 ROUTE 130 NORTH
Mailing Address - Street 2:SUITE K
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902
Mailing Address - Country:US
Mailing Address - Phone:732-422-9400
Mailing Address - Fax:732-274-0023
Practice Address - Street 1:1626 ROUTE 130 N.
Practice Address - Street 2:SUITE K
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902
Practice Address - Country:US
Practice Address - Phone:732-422-9400
Practice Address - Fax:732-274-0023
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSC000461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJSC00046OtherLICENSE NUMBER
NJ710968226OtherEMPLOYEE IDENTIFICATION #
NJ710968226OtherEMPLOYEE IDENTIFICATION #