MEDICARE: PATRICIA JO BISHOP LCSW

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
1	1041C0700X	Clinical Social Worker	LCSW-13022	AZ
2	1041C0700X	Clinical Social Worker	LSW0000009002	TN

General Provider Information

NPI Number	:	1740556919
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA JO BISHOP LCSW

Provider Business Mailing Address
First Line	:	10933 ANCHORAGE CIR
Second Line	:
City	:	FARRAGUT
State	:	TN
Zip	:	37934-3908
Country	:	US
Telephone Number	:	865-203-5091
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 PROSPERITY DR STE 220
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37923-4718
Country	:	US
Telephone Number	:	480-313-8175
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2012
Last Update Date	:	05/13/2024

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