Provider Demographics
NPI:1770696452
Name:SHAPIRO, RICHARD SCOTT (PHD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:SCOTT
Last Name:SHAPIRO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:857 POST RD # 316
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-6041
Mailing Address - Country:US
Mailing Address - Phone:203-254-3800
Mailing Address - Fax:
Practice Address - Street 1:1708 PEACHTREE RD NW
Practice Address - Street 2:STE 400
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309
Practice Address - Country:US
Practice Address - Phone:203-254-3800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001081103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical