Provider Demographics
NPI:1942641568
Name:DAVID A SHAPIRO, PH.D., P.C.
Entity Type:Organization
Organization Name:DAVID A SHAPIRO, PH.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ADAM
Authorized Official - Last Name:SHAPIRO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:719-634-6887
Mailing Address - Street 1:1301 S 8TH ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80905-7335
Mailing Address - Country:US
Mailing Address - Phone:719-634-6887
Mailing Address - Fax:719-630-7858
Practice Address - Street 1:1301 S 8TH ST
Practice Address - Street 2:SUITE 301
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80905-7335
Practice Address - Country:US
Practice Address - Phone:719-634-6887
Practice Address - Fax:719-630-7858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-11
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC84106Medicare UPIN