Provider Demographics
NPI:1356463103
Name:BISHOP, JEFFREY TODD (LSW)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:TODD
Last Name:BISHOP
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10100 ELIDA RD
Mailing Address - Street 2:
Mailing Address - City:DELPHOS
Mailing Address - State:OH
Mailing Address - Zip Code:45833-9056
Mailing Address - Country:US
Mailing Address - Phone:419-685-8010
Mailing Address - Fax:419-932-6232
Practice Address - Street 1:1624 TIFFIN AVE STE A
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-6852
Practice Address - Country:US
Practice Address - Phone:419-427-3320
Practice Address - Fax:419-427-1697
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS 0020397104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker