Provider Demographics
NPI:1942209598
Name:SHAPIRO, SUSAN JANINE (LCSW)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:JANINE
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 1:499 E CENTRAL PKWY
Mailing Address - Street 2:SUITE 150
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-3402
Mailing Address - Country:US
Mailing Address - Phone:407-260-1001
Mailing Address - Fax:407-260-9009
Practice Address - Street 1:499 E CENTRAL PKWY
Practice Address - Street 2:SUITE 150
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-3402
Practice Address - Country:US
Practice Address - Phone:407-260-1001
Practice Address - Fax:407-260-9009
Is Sole Proprietor?:No
Enumeration Date:2005-07-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW28971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical