Provider Demographics
NPI:1780994129
Name:SHAPIRO, CAPPY RAE (LICSW)
Entity type:Individual
Prefix:MISS
First Name:CAPPY
Middle Name:RAE
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:LAUREN
Other - Last Name:SHAPIRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CSW
Mailing Address - Street 1:425 E 200 S
Mailing Address - Street 2:APT 23
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84111-2129
Mailing Address - Country:US
Mailing Address - Phone:510-653-5040
Mailing Address - Fax:
Practice Address - Street 1:255 E 400 S
Practice Address - Street 2:SUITE 200
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84111-2846
Practice Address - Country:US
Practice Address - Phone:801-539-8800
Practice Address - Fax:801-606-7743
Is Sole Proprietor?:No
Enumeration Date:2010-10-19
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 101YM0800X
UT8822898-3502104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health