Healthcare Provider Details

I. General information

NPI: 1235069998
Provider Name (Legal Business Name): SOFIA BISHOFF LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

495 E MAIN ST
COLUMBUS OH
43215-5679
US

IV. Provider business mailing address

4944 MULEADY CT
COLUMBUS OH
43221-5240
US

V. Phone/Fax

Practice location:
  • Phone: 614-355-8070
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberS.2512708
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: