Individual provider Active NPI

Deborah Lynn Shapiro, PH.D.

  • Clinical Psychologist
  • Baltimore, MD
National Provider Identifier
1447337233
Registry record updated Jun 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
03960 Issued in MD
Practice address
1501 Sulgrave Ave
Ste 308
Baltimore, MD 21209-3651
Phone
(410) 889-1101
Fax
(410) 889-8971
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 03960 MD Primary

Addresses

Primary practice location

1501 Sulgrave Ave
Ste 308
Baltimore, MD 21209-3651

Mailing address

1501 Sulgrave Ave
Ste 308
Baltimore, MD 21209-3651
Phone (410) 889-1101

Other identifiers 1

IdentifierTypeStateIssuer
001831700MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040721000060 MD Practitioner - Clinical Psychologist 7416937511 Practice locations: Baltimore, MD

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1501 Sulgrave Ave
Suite 308
Baltimore, MD 21209-3651
Phone (410) 889-1101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
03960MDMDClinical Psychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529625600000",
    "number": "1447337233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 SULGRAVE AVE",
            "address_2": "STE 308",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212093651",
            "telephone_number": "410-889-1101",
            "fax_number": "410-664-1203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 SULGRAVE AVE",
            "address_2": "STE 308",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212093651",
            "telephone_number": "410-889-1101",
            "fax_number": "410-889-8971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAPIRO",
        "first_name": "DEBORAH",
        "middle_name": "LYNN",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2018-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "03960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001831700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.