MEDICARE: ALLISON BISHOP LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	SW18613	FL

General Provider Information

NPI Number	:	1497597389
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLISON BISHOP LCSW

Provider Business Mailing Address
First Line	:	2640 LAKE SHORE DR UNIT 312
Second Line	:
City	:	RIVIERA BEACH
State	:	FL
Zip	:	33404-4667
Country	:	US
Telephone Number	:	561-373-7994
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 VILLAGE SQUARE XING STE 106
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-4531
Country	:	US
Telephone Number	:	561-373-7994
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/11/2024
Last Update Date	:	06/11/2024

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Directions to “ ALLISON BISHOP LCSW” Practice Location

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