Provider Demographics
NPI:1255687331
Name:ASSOCIATES IN BEHAVIORAL COUNSELING, LLC
Entity Type:Organization
Organization Name:ASSOCIATES IN BEHAVIORAL COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:A
Authorized Official - Last Name:BISHOP
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:970-245-3212
Mailing Address - Street 1:518 28 RD
Mailing Address - Street 2:A207
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-6556
Mailing Address - Country:US
Mailing Address - Phone:970-245-3212
Mailing Address - Fax:970-245-3216
Practice Address - Street 1:518 28 RD
Practice Address - Street 2:A207
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-6556
Practice Address - Country:US
Practice Address - Phone:970-245-3212
Practice Address - Fax:970-245-3216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-26
Last Update Date:2012-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2858103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty