Provider Demographics
NPI:1427123959
Name:BISHOP, TROY (LCSW)
Entity type:Individual
Prefix:
First Name:TROY
Middle Name:
Last Name:BISHOP
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:276 RIVER VISTA PL
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-3006
Mailing Address - Country:US
Mailing Address - Phone:208-733-1131
Mailing Address - Fax:208-733-1141
Practice Address - Street 1:276 RIVER VISTA PL
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-3006
Practice Address - Country:US
Practice Address - Phone:208-733-1131
Practice Address - Fax:208-733-1141
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW 25732101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health