Provider Demographics
NPI:1255477576
Name:SHAPIRO, SYLVIA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SYLVIA
Middle Name:
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 PROSPECT AVENUE
Mailing Address - Street 2:#694
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-7700
Mailing Address - Country:US
Mailing Address - Phone:201-968-1567
Mailing Address - Fax:
Practice Address - Street 1:240 PROSPECT AVENUE
Practice Address - Street 2:#694
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601
Practice Address - Country:US
Practice Address - Phone:201-968-1567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC002886001041C0700X
NYPR00126011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ638899Medicare ID - Type Unspecified