Provider Demographics
NPI:1538540265
Name:SHAPIRO, SUSANNA (LCSW-C)
Entity type:Individual
Prefix:MS
First Name:SUSANNA
Middle Name:
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9826 HOLLOW GLEN PL
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-1138
Mailing Address - Country:US
Mailing Address - Phone:301-204-2228
Mailing Address - Fax:
Practice Address - Street 1:13975 CONNECTICUT AVE STE 250
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-2900
Practice Address - Country:US
Practice Address - Phone:301-557-1911
Practice Address - Fax:301-557-1949
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-18
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD208071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical