Provider Demographics
NPI:1164572277
Name:SHAPSE, STEVEN NEIL (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:NEIL
Last Name:SHAPSE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 LINCOLN RD
Mailing Address - Street 2:PO BOX 112
Mailing Address - City:LINCOLN
Mailing Address - State:MA
Mailing Address - Zip Code:01773-3840
Mailing Address - Country:US
Mailing Address - Phone:781-259-0283
Mailing Address - Fax:
Practice Address - Street 1:145 LINCOLN RD
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:MA
Practice Address - Zip Code:01773-3840
Practice Address - Country:US
Practice Address - Phone:781-259-0283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2806103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW02949OtherBLUECROSS BLUE SHIELD
MAVC6000199071OtherVENDOR WEB-MASS FINANCE
MAW02949Medicare ID - Type UnspecifiedBLUECROSS BLUE SHIELD