Provider Demographics
NPI:1477982122
Name:BISHOP, ELIZABETH HEATHER (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:HEATHER
Last Name:BISHOP
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:939 39TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33703-5924
Mailing Address - Country:US
Mailing Address - Phone:727-421-2200
Mailing Address - Fax:
Practice Address - Street 1:8081 38TH AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-1029
Practice Address - Country:US
Practice Address - Phone:727-345-2667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-04
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH7475101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health