Healthcare Provider Details

I. General information

NPI: 1174002471
Provider Name (Legal Business Name): JENNY BISHOP LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2018
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

396 S HILLS DR.
BATTLE CREEK MI
49015-3954
US

IV. Provider business mailing address

396 S HILLS DR.
BATTLE CREEK MI
49015-3954
US

V. Phone/Fax

Practice location:
  • Phone: 517-343-6090
  • Fax: 517-343-6094
Mailing address:
  • Phone: 517-343-6090
  • Fax: 517-343-6094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801106673
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: