Healthcare Provider Details

I. General information

NPI: 1154136422
Provider Name (Legal Business Name): JENNIFER BISHOP MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2025
Last Update Date: 06/06/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

192 OLD WOOLEN MILL LN
LEXINGTON KY
40511-7005
US

IV. Provider business mailing address

192 OLD WOOLEN MILL LN
LEXINGTON KY
40511-7005
US

V. Phone/Fax

Practice location:
  • Phone: 859-312-3652
  • Fax:
Mailing address:
  • Phone: 859-312-3652
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLCSW00001609
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: