Healthcare Provider Details

I. General information

NPI: 1871043547
Provider Name (Legal Business Name): JANICE DENISE BISHOP LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JANICE DENISE SWAIN-BISHOP LISW

II. Dates (important events)

Enumeration Date: 10/06/2016
Last Update Date: 11/08/2023
Certification Date: 11/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 ALBERT SABIN WAY
CINCINNATI OH
45229-2838
US

IV. Provider business mailing address

311 ALBERT SABIN WAY
CINCINNATI OH
45229-2838
US

V. Phone/Fax

Practice location:
  • Phone: 513-558-6512
  • Fax: 513-558-2701
Mailing address:
  • Phone: 513-558-6512
  • Fax: 513-558-2701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.1600180-SUPV
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: