Provider Demographics
NPI:1285207803
Name:SHAPIRO, SARA VICKERS (MSW, LMSW, LCSW)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:VICKERS
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:MSW, LMSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 SUSSEX RD
Mailing Address - Street 2:
Mailing Address - City:BERGENFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07621-4011
Mailing Address - Country:US
Mailing Address - Phone:516-637-3758
Mailing Address - Fax:
Practice Address - Street 1:15 SUSSEX RD
Practice Address - Street 2:
Practice Address - City:BERGENFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07621-4011
Practice Address - Country:US
Practice Address - Phone:516-637-3758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-21
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0912901041C0700X
NJ44SC060615001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical