Provider Demographics
NPI:1174335871
Name:SHAPIRO, LAWRENCE MILTON (LMSW)
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:MILTON
Last Name:SHAPIRO
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3676 N HARBOR LN STE 100
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83703-6919
Mailing Address - Country:US
Mailing Address - Phone:208-495-6787
Mailing Address - Fax:
Practice Address - Street 1:3676 N HARBOR LN STE 100
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83703-6919
Practice Address - Country:US
Practice Address - Phone:208-607-3503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-21
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID25717401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical