Basic Information
| Provider Information | |||||||||
| NPI: | 1962476689 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SHAPIRO | ||||||||
| FirstName: | LESLIE | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | LSCSW | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | COUCH-SHAPIRO | ||||||||
| OtherFirstName: | LESLIE | ||||||||
| OtherMiddleName: | M | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | LSCSW | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 8787 BALLENTINE | ||||||||
| Address2: | STE 1200 | ||||||||
| City: | OVERLAND PARK | ||||||||
| State: | KS | ||||||||
| PostalCode: | 66214 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9133399933 | ||||||||
| FaxNumber: | 9133399915 | ||||||||
| Practice Location | |||||||||
| Address1: | 8787 BALLENTINE | ||||||||
| Address2: | STE 1200 | ||||||||
| City: | OVERLAND PARK | ||||||||
| State: | KS | ||||||||
| PostalCode: | 66214 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9133399933 | ||||||||
| FaxNumber: | 9133399915 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/17/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 2278 | KS | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041C0700X | 001221 | MO | N | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.