Provider Demographics
NPI:1942352521
Name:SHAPIRO, LINDA S (MSW LCSWC)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:S
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:MSW LCSWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3635 OLD COURT RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21208
Mailing Address - Country:US
Mailing Address - Phone:410-653-2794
Mailing Address - Fax:410-653-5045
Practice Address - Street 1:3635 OLD COURT RD
Practice Address - Street 2:SUITE 210
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21208
Practice Address - Country:US
Practice Address - Phone:410-653-2794
Practice Address - Fax:410-653-5045
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD005661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
R09874Medicare UPIN
MDQ082Medicare ID - Type Unspecified