Healthcare Provider Details

I. General information

NPI: 1316227663
Provider Name (Legal Business Name): LAUREN P BISHOP PPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2011
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1729 E GARRISON BLVD BLDG 1815
GASTONIA NC
28054-4837
US

IV. Provider business mailing address

1729 E GARRISON BLVD BLDG 1815
GASTONIA NC
28054-4837
US

V. Phone/Fax

Practice location:
  • Phone: 307-200-9343
  • Fax:
Mailing address:
  • Phone: 307-200-9343
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number19102
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: