Provider Demographics
NPI:1093239097
Name:BISHOP, STEPHANIE JO (MSW, LISW-S)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:JO
Last Name:BISHOP
Suffix:
Gender:F
Credentials:MSW, LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:184 FAIRFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-4628
Mailing Address - Country:US
Mailing Address - Phone:740-641-8654
Mailing Address - Fax:
Practice Address - Street 1:445 E DUBLIN GRANVILLE RD
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-3192
Practice Address - Country:US
Practice Address - Phone:614-844-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-01
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHS.1701226OtherOHIO CSWMFT
OHI.2002032OtherOHIO CSWMFT