Provider Demographics
NPI:1336439728
Name:SHAPIRO, LAWRENCE E (PHD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:E
Last Name:SHAPIRO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
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Mailing Address - Street 1:665 S SKINKER BLVD APT 16B
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63105-2353
Mailing Address - Country:US
Mailing Address - Phone:314-809-3964
Mailing Address - Fax:
Practice Address - Street 1:1129 MACKLIND AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1440
Practice Address - Country:US
Practice Address - Phone:314-534-0200
Practice Address - Fax:314-534-7996
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-19
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2010040770103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO232812942OtherST LOUIS BEHAVIORAL MEDICINE INSTITUTE