Provider Demographics
NPI:1558447284
Name:SHAPIRO, NANETTE (LCSW)
Entity Type:Individual
Prefix:
First Name:NANETTE
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 1:135 ELLIOT RD
Mailing Address - Street 2:
Mailing Address - City:EAST GREENBUSH
Mailing Address - State:NY
Mailing Address - Zip Code:12061-3834
Mailing Address - Country:US
Mailing Address - Phone:518-477-9772
Mailing Address - Fax:
Practice Address - Street 1:135 ELLIOT RD
Practice Address - Street 2:
Practice Address - City:EAST GREENBUSH
Practice Address - State:NY
Practice Address - Zip Code:12061-3834
Practice Address - Country:US
Practice Address - Phone:518-477-9772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0172651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY10001875OtherCDPHP
NY000406664001OtherBLUE SHIELD
NY0068354004OtherVALUE OPTIONS
NY000406664001OtherBLUE SHIELD