Provider Demographics
NPI:1265876361
Name:SHAPIRO, BETH MARYA (PHD, MSSA, LISW-S)
Entity type:Individual
Prefix:DR
First Name:BETH
Middle Name:MARYA
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:PHD, MSSA, LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 241246
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44124-8846
Mailing Address - Country:US
Mailing Address - Phone:440-665-1340
Mailing Address - Fax:216-321-1511
Practice Address - Street 1:2055 LEE RD
Practice Address - Street 2:2ND FLOOR, REAR
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44118-2560
Practice Address - Country:US
Practice Address - Phone:440-665-1340
Practice Address - Fax:216-321-1511
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-19
Last Update Date:2014-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI0008287 SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH189770Medicare PIN