Provider Demographics
NPI:1336475151
Name:SHAPIRO, MARLENE IRIS (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:MARLENE
Middle Name:IRIS
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 SULGRAVE AVE STE 306
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-3651
Mailing Address - Country:US
Mailing Address - Phone:410-654-1558
Mailing Address - Fax:
Practice Address - Street 1:1501 SULGRAVE AVE STE 306
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-3651
Practice Address - Country:US
Practice Address - Phone:410-654-1558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-29
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05702104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker