Provider Demographics
NPI:1710232343
Name:SHAPIRO, ZACHARY D (LMSW)
Entity Type:Individual
Prefix:MR
First Name:ZACHARY
Middle Name:D
Last Name:SHAPIRO
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:MR
Other - First Name:ZACHARY
Other - Middle Name:D
Other - Last Name:SHAPIRO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:6120 WOODSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-3577
Mailing Address - Country:US
Mailing Address - Phone:646-872-5352
Mailing Address - Fax:
Practice Address - Street 1:61-20 WOODSIDE AVE
Practice Address - Street 2:
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-3577
Practice Address - Country:US
Practice Address - Phone:646-872-5352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-19
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY085950-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical