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NPI Code Detail

MEDICARE: JAMES SAMUEL BISHOP MA, LCMHCA

MEDICARE: JAMES SAMUEL BISHOP MA, LCMHCA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorA21905NC

General Provider Information

NPI Number : 1457239071
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES SAMUEL BISHOP MA, LCMHCA
Provider Business Mailing Address
First Line : 160 CROWNE CHASE DR APT 13
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27104-3585
Country : US
Telephone Number : 334-590-8210
Fax Number :
Provider Business Practice Location Address
First Line : 2121 EASTCHESTER DR STE 105
Second Line :
City : HIGH POINT
State : NC
Zip : 27265-1535
Country : US
Telephone Number : 336-322-2277
Fax Number : 336-346-8444
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2025
Last Update Date : 08/22/2025

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