Provider Demographics
NPI:1629213087
Name:BISHOP, ROY E (MSW)
Entity Type:Individual
Prefix:
First Name:ROY
Middle Name:E
Last Name:BISHOP
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 ELM GROVE RD
Mailing Address - Street 2:STE 325
Mailing Address - City:ELM GROVE
Mailing Address - State:WI
Mailing Address - Zip Code:53122-2561
Mailing Address - Country:US
Mailing Address - Phone:262-245-1949
Mailing Address - Fax:
Practice Address - Street 1:1219 N CASS ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-2770
Practice Address - Country:US
Practice Address - Phone:414-342-0401
Practice Address - Fax:262-782-7815
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-12
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor