Provider Demographics
NPI:1699844787
Name:SHAPIRO, RHODA E (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:RHODA
Middle Name:E
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:ONE IPSWICH AVE
Mailing Address - Street 2:APT 328
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021
Mailing Address - Country:US
Mailing Address - Phone:576-466-4050
Mailing Address - Fax:576-466-2993
Practice Address - Street 1:12 WELWYN ROAD
Practice Address - Street 2:SUITE C D
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021
Practice Address - Country:US
Practice Address - Phone:576-466-4050
Practice Address - Fax:576-466-2993
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR002981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical