Provider Demographics
NPI:1568600211
Name:BISHOP ABSOLUTE PSYCHOLOGICAL SERVICES, INC.
Entity Type:Organization
Organization Name:BISHOP ABSOLUTE PSYCHOLOGICAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BONNI
Authorized Official - Middle Name:S
Authorized Official - Last Name:BISHOP
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:813-361-2709
Mailing Address - Street 1:16213 TERNGLADE DR
Mailing Address - Street 2:
Mailing Address - City:LITHIA
Mailing Address - State:FL
Mailing Address - Zip Code:33547-5844
Mailing Address - Country:US
Mailing Address - Phone:813-361-2709
Mailing Address - Fax:
Practice Address - Street 1:16213 TERNGLADE DR
Practice Address - Street 2:
Practice Address - City:LITHIA
Practice Address - State:FL
Practice Address - Zip Code:33547-5844
Practice Address - Country:US
Practice Address - Phone:813-361-2709
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-02
Last Update Date:2010-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7847251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health