Provider Demographics
NPI:1699484717
Name:BISHOP, JOHN N (LPC-A)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:N
Last Name:BISHOP
Suffix:
Gender:M
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 LONESTAR DR
Mailing Address - Street 2:
Mailing Address - City:KEMPNER
Mailing Address - State:TX
Mailing Address - Zip Code:76539-5007
Mailing Address - Country:US
Mailing Address - Phone:512-966-7941
Mailing Address - Fax:
Practice Address - Street 1:8500 N MOPAC EXPY STE 402
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8347
Practice Address - Country:US
Practice Address - Phone:512-902-3282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-17
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX88256101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional