Provider Demographics
NPI:1124788435
Name:BISHOP, DEBORAH ODETTE (MSW)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ODETTE
Last Name:BISHOP
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:ODETTE
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3450 N HUALAPAI WAY UNIT 2095
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-8086
Mailing Address - Country:US
Mailing Address - Phone:702-767-8933
Mailing Address - Fax:
Practice Address - Street 1:4055 SPENCER ST STE 118
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5250
Practice Address - Country:US
Practice Address - Phone:702-799-9710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-28
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVIC-18891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical