Provider Demographics
NPI:1912009804
Name:SHAPIRO, TODD A (LCSW, MPA)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:A
Last Name:SHAPIRO
Suffix:
Gender:M
Credentials:LCSW, MPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7673 RIDGELAKE CIR
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34203-2508
Mailing Address - Country:US
Mailing Address - Phone:941-900-8661
Mailing Address - Fax:
Practice Address - Street 1:7673 RIDGELAKE CIR
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34203-2508
Practice Address - Country:US
Practice Address - Phone:941-900-8661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0033441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004260072OtherCT. BEHAV. HEALTH PARTNER