MEDICARE: HYBRIE BISHOP MSW, 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	2019036127	MO

General Provider Information

NPI Number	:	1821632878
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HYBRIE BISHOP MSW, LCSW

Provider Business Mailing Address
First Line	:	7733 FORSYTH BLVD FL 11
Second Line	:
City	:	CLAYTON
State	:	MO
Zip	:	63105-1878
Country	:	US
Telephone Number	:	314-629-4703
Fax Number	:

Provider Business Practice Location Address
First Line	:	8669 DELMAR BLVD APT A
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63124-1946
Country	:	US
Telephone Number	:	314-629-4703
Fax Number	:

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

Provider Enumeration Date	:	11/03/2019
Last Update Date	:	08/03/2021

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