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General NPI Number Information
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NPI Number | 1508115668
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Entity Type | Individual
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Provider Name | MICHAEL SHAPIRO PH.D.
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Gender | Male
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Dates
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Enumeration Date | 09/05/2012
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Last Update Date | 10/30/2024
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Provider Practice Location Address
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Address Line | 812 E HIGH ST
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22902-5126
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Country | US
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Telephone | 434-542-8421
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Fax |
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Provider Business Mailing Address
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Address Line | 1516 RUTLEDGE AVE
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22903-1418
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Country | US
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Telephone | 847-323-9510
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PS017314
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | P3385
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 0810005975
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License Number State | VA
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