Provider Demographics
NPI:1154492965
Name:SHAPIRO, NATALIE L (LCSW MSW)
Entity Type:Individual
Prefix:MS
First Name:NATALIE
Middle Name:L
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:LCSW MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 THORNWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:E SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-1825
Mailing Address - Country:US
Mailing Address - Phone:631-751-8328
Mailing Address - Fax:631-751-8328
Practice Address - Street 1:14 THORNWOOD WAY
Practice Address - Street 2:
Practice Address - City:E SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-1825
Practice Address - Country:US
Practice Address - Phone:631-751-8328
Practice Address - Fax:631-751-8328
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032369R103T00000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
N04581Medicare ID - Type Unspecified