Provider Demographics
NPI:1295959906
Name:SHAPIRO, JANE LOUISE (PHD)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:LOUISE
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 1:22 STOCKTON STREET
Mailing Address - Street 2:TRINITY COUNSELING SERVICE
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540
Mailing Address - Country:US
Mailing Address - Phone:908-420-9364
Mailing Address - Fax:
Practice Address - Street 1:22 STOCKTON ST
Practice Address - Street 2:TRINITY COUNSELING SERVICE
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-6813
Practice Address - Country:US
Practice Address - Phone:908-420-9364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00425200103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical