MEDICARE: JILL ELLEN SHAPIRO LLC/C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	CC3744	ME

General Provider Information

NPI Number	:	1922252147
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JILL ELLEN SHAPIRO LLC/C

Provider Business Mailing Address
First Line	:	899 RIVERSIDE ST
Second Line	:
City	:	PORTLAND
State	:	ME
Zip	:	04103-1070
Country	:	US
Telephone Number	:	207-871-1200
Fax Number	:	207-871-1232

Provider Business Practice Location Address
First Line	:	901 WASHINGTON AVE
Second Line	:
City	:	PORTLAND
State	:	ME
Zip	:	04103-2737
Country	:	US
Telephone Number	:	207-776-5637
Fax Number	:	207-871-1237

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2008
Last Update Date	:	07/31/2025

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