Provider Demographics
NPI:1164563177
Name:SHAPIRO, NAOMI P (MSW, BCD)
Entity Type:Individual
Prefix:MS
First Name:NAOMI
Middle Name:P
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:MSW, BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 BUTTERNUT LN
Mailing Address - Street 2:
Mailing Address - City:SHELBURNE
Mailing Address - State:VT
Mailing Address - Zip Code:05482-6925
Mailing Address - Country:US
Mailing Address - Phone:802-985-5702
Mailing Address - Fax:
Practice Address - Street 1:29 ETHAN ALLEN AVE
Practice Address - Street 2:
Practice Address - City:COLCHESTER
Practice Address - State:VT
Practice Address - Zip Code:05446-3305
Practice Address - Country:US
Practice Address - Phone:802-654-7075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT089-00000661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical