Healthcare Provider Details

I. General information

NPI: 1376414078
Provider Name (Legal Business Name): BISHOPWOOD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2025
Last Update Date: 02/18/2026
Certification Date: 02/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5733 ALLENDER RD
WHITE MARSH MD
21162-1306
US

IV. Provider business mailing address

5733 ALLENDER RD
WHITE MARSH MD
21162-1306
US

V. Phone/Fax

Practice location:
  • Phone: 443-504-8404
  • Fax:
Mailing address:
  • Phone: 443-504-8404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL P WOOD
Title or Position: OWNER
Credential: LCPC
Phone: 443-504-8404