Provider Demographics
NPI:1972700425
Name:SHAPIRO, MARGO M (MFT #34624)
Entity Type:Individual
Prefix:MS
First Name:MARGO
Middle Name:M
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:MFT #34624
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13928 MOUNTAIN VIEW PL
Mailing Address - Street 2:
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91342-1975
Mailing Address - Country:US
Mailing Address - Phone:818-758-1282
Mailing Address - Fax:818-758-1360
Practice Address - Street 1:18040 SHERMAN WAY
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-4631
Practice Address - Country:US
Practice Address - Phone:818-758-1282
Practice Address - Fax:818-758-1360
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 34624106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist