| Ellen Shapiro Llc | |
|
1003 N Adams St Tallahassee FL 32303-6132 | |
| (850) 222-0003 | |
| (850) 222-1311 |
| Full Name | Ellen Shapiro Llc |
|---|---|
| Speciality | Psychologist |
| Location | 1003 N Adams St, Tallahassee, Florida |
| Authorized Official Name and Position | Ellen Shapiro (MEMBER/PSYCHOLOGIST) |
| Authorized Official Contact | 8505562625 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellen Shapiro Llc 1003 N Adams St Tallahassee FL 32303-6132 Ph: (850) 222-0003 | Ellen Shapiro Llc 1003 N Adams St Tallahassee FL 32303-6132 Ph: (850) 222-0003 |
| NPI Number | 1497144661 |
|---|---|
| Provider Enumeration Date | 01/12/2015 |
| Last Update Date | 01/14/2015 |
| Medicare PECOS PAC ID | 9234457169 |
|---|---|
| Medicare Enrollment ID | O20150406000857 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497144661 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY 3674 (Florida) | Primary |
| Provider Name | Ellen Shapiro |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356408264 PECOS PAC ID: 4183813439 Enrollment ID: I20110118000953 |
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