Provider Demographics
NPI:1679838866
Name:SHAPIRO-LEE, LIANA S (MA)
Entity Type:Individual
Prefix:
First Name:LIANA
Middle Name:S
Last Name:SHAPIRO-LEE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:LIANA
Other - Middle Name:S
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:191 LIGHTHOUSE AVE STE A5
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-1704
Mailing Address - Country:US
Mailing Address - Phone:831-737-8295
Mailing Address - Fax:831-740-6967
Practice Address - Street 1:191 LIGHTHOUSE AVE STE A5
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940
Practice Address - Country:US
Practice Address - Phone:831-737-8295
Practice Address - Fax:831-740-6967
Is Sole Proprietor?:No
Enumeration Date:2012-07-12
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CALMFT99703106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health