Provider Demographics
NPI:1558677559
Name:LISA BISHOP, MCD,CCC-SLP
Entity Type:Organization
Organization Name:LISA BISHOP, MCD,CCC-SLP
Other - Org Name:ACCESS THERAPIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SLP/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:COX
Authorized Official - Last Name:BISHOP
Authorized Official - Suffix:
Authorized Official - Credentials:MCD,CCC-SLP
Authorized Official - Phone:864-838-0768
Mailing Address - Street 1:1077 CORIE CREST DRIVE
Mailing Address - Street 2:
Mailing Address - City:BOILING SPRINGS
Mailing Address - State:SC
Mailing Address - Zip Code:29316
Mailing Address - Country:US
Mailing Address - Phone:864-838-0768
Mailing Address - Fax:864-752-1072
Practice Address - Street 1:109 A CHELLE LIN DRIVE
Practice Address - Street 2:
Practice Address - City:GAFFNEY
Practice Address - State:SC
Practice Address - Zip Code:29341
Practice Address - Country:US
Practice Address - Phone:864-838-0768
Practice Address - Fax:864-752-1072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-27
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3919235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSA-0745Medicaid