Provider Demographics
NPI:1245306620
Name:SHAPIRO, LINDA S (PHD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:S
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 NEW KARNER RD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-3833
Mailing Address - Country:US
Mailing Address - Phone:518-456-2060
Mailing Address - Fax:518-456-2361
Practice Address - Street 1:435 NEW KARNER RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-3833
Practice Address - Country:US
Practice Address - Phone:518-456-2060
Practice Address - Fax:518-456-2361
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009468103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical