Provider Demographics
NPI:1114402385
Name:BISHOP, LINDSEY (SLP)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:BISHOP
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 BERKLEY ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:VA
Mailing Address - Zip Code:23005-1302
Mailing Address - Country:US
Mailing Address - Phone:804-723-3660
Mailing Address - Fax:
Practice Address - Street 1:8290 NEW ASHCAKE RD
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-4033
Practice Address - Country:US
Practice Address - Phone:804-723-3660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-03
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202005356235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2202005356Medicaid