Provider Demographics
NPI:1386656676
Name:BISHOP, LORI S (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:S
Last Name:BISHOP
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1059 S BRADFORD ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-4141
Mailing Address - Country:US
Mailing Address - Phone:302-736-6135
Mailing Address - Fax:302-736-0172
Practice Address - Street 1:1059 S BRADFORD ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-4141
Practice Address - Country:US
Practice Address - Phone:302-736-6135
Practice Address - Fax:302-736-0172
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00006371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000030160Medicaid