Basic Information
| Provider Information | |||||||||
| NPI: | 1396770632 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SHAPIRO | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | |||||||||
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| Credential: | LICSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 40 WRIGHT STREET | ||||||||
| Address2: | |||||||||
| City: | PALMER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01069 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4132837651 | ||||||||
| FaxNumber: | 4132845117 | ||||||||
| Practice Location | |||||||||
| Address1: | WING MEMORIAL HOSPITAL GRISWOLD CENTER | ||||||||
| Address2: | 40 WRIGHT STREET | ||||||||
| City: | PALMER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01069 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4132845285 | ||||||||
| FaxNumber: | 4132845384 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/12/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 1022128 | MA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.