Provider Demographics
NPI:1942698253
Name:SHAPIRO, NOAH (LCSW)
Entity Type:Individual
Prefix:MR
First Name:NOAH
Middle Name:
Last Name:SHAPIRO
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9140 BRADSHAW RD
Mailing Address - Street 2:
Mailing Address - City:ELF GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624
Mailing Address - Country:US
Mailing Address - Phone:916-686-5210
Mailing Address - Fax:
Practice Address - Street 1:9140 BRADSHAW RD
Practice Address - Street 2:
Practice Address - City:ELF GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624
Practice Address - Country:US
Practice Address - Phone:916-686-5210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-08
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW837101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical