Provider Demographics
NPI:1649425133
Name:SHAPIRO, MELANIE ANN (LCSW MSW ALSW,RN)
Entity type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:ANN
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:LCSW MSW ALSW,RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:618 BETSY ROSS PLACE
Mailing Address - Street 2:
Mailing Address - City:BOUND BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:08805-1322
Mailing Address - Country:US
Mailing Address - Phone:732-735-7793
Mailing Address - Fax:
Practice Address - Street 1:618 BETSY ROSS PLACE
Practice Address - Street 2:
Practice Address - City:BOUND BROOK
Practice Address - State:NJ
Practice Address - Zip Code:08805-1322
Practice Address - Country:US
Practice Address - Phone:732-735-7793
Practice Address - Fax:732-271-2533
Is Sole Proprietor?:No
Enumeration Date:2008-11-25
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC013746001041C0700X
NJ26NR18910100163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ26NR18910100OtherR.N. LICENSE