Provider Demographics
NPI:1336963644
Name:BISHOP, BETHANY (LMSW)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:
Last Name:BISHOP
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3016 INDEPENDENCE DR STE 105
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78132-4478
Mailing Address - Country:US
Mailing Address - Phone:830-251-2933
Mailing Address - Fax:
Practice Address - Street 1:3016 INDEPENDENCE DR STE 105
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78132-4478
Practice Address - Country:US
Practice Address - Phone:830-251-2933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX58791104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker