Provider Demographics
NPI:1548206592
Name:SHAPIRO, SUSAN R (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:R
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4001 KNIGHTS BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-1743
Mailing Address - Country:US
Mailing Address - Phone:405-573-9905
Mailing Address - Fax:405-573-0404
Practice Address - Street 1:10101 S PENNSYLVANIA AVE
Practice Address - Street 2:SUITE J
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159-6929
Practice Address - Country:US
Practice Address - Phone:405-573-9905
Practice Address - Fax:405-573-0404
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK17461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical