Provider Demographics
NPI:1730659103
Name:LIANA SHAPIRO-LEE, LICENSED MARRIAGE AND FAMILY THERAPY, A PROFESSIONA
Entity Type:Organization
Organization Name:LIANA SHAPIRO-LEE, LICENSED MARRIAGE AND FAMILY THERAPY, A PROFESSIONA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAPIRO-LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:831-737-8295
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:831-740-6769
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:93940-1704
Practice Address - Country:US
Practice Address - Phone:831-737-8295
Practice Address - Fax:831-740-6769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-28
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1679838866OtherINDIVIDUAL NPI