Provider Demographics
NPI:1225107147
Name:SHAPIRO, RACHAEL (MSW)
Entity Type:Individual
Prefix:MS
First Name:RACHAEL
Middle Name:
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 RACHEL CARSON WAY
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-8402
Mailing Address - Country:US
Mailing Address - Phone:607-275-0249
Mailing Address - Fax:607-273-5818
Practice Address - Street 1:211 RACHEL CARSON WAY
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-8402
Practice Address - Country:US
Practice Address - Phone:607-275-0249
Practice Address - Fax:607-273-5818
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0545651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical