Healthcare Provider Details

I. General information

NPI: 1508428202
Provider Name (Legal Business Name): SARINIA SHERELL BISHOP MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2019
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2670 DURHAM CHAPEL HILL BLVD
DURHAM NC
27707-2829
US

IV. Provider business mailing address

711 KEYSTONE PARK DR
MORRISVILLE NC
27560-6827
US

V. Phone/Fax

Practice location:
  • Phone: 919-341-9006
  • Fax: 919-205-1512
Mailing address:
  • Phone: 252-375-1566
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC014360
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLCAS-25758
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904014913
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: