Provider Demographics
NPI:1720229073
Name:BISHOP, CATHERINE ANN (MS, LPC, NCC, LADC)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:ANN
Last Name:BISHOP
Suffix:
Gender:F
Credentials:MS, LPC, NCC, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12005 E 470 RD
Mailing Address - Street 2:
Mailing Address - City:CLAREMORE
Mailing Address - State:OK
Mailing Address - Zip Code:74017-3737
Mailing Address - Country:US
Mailing Address - Phone:918-342-0770
Mailing Address - Fax:918-582-6405
Practice Address - Street 1:12005 E 470 RD
Practice Address - Street 2:
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74017-3737
Practice Address - Country:US
Practice Address - Phone:918-342-0770
Practice Address - Fax:918-582-6405
Is Sole Proprietor?:No
Enumeration Date:2009-03-17
Last Update Date:2017-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4570101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100732910-GOtherGROUP MEDICAID/SOONERCARE
OK731042545001OtherGROUP TRICARE
OK73-1042545OtherGROUP BCBS
OK100732910-AOtherGROUP MEDICAID/SOONERCARE
OK73-1042545OtherGROUP COMMUNITY CARE OF OKLAHOMA
OK73-1042545OtherGROUP MEDICARE
OK200474700-AMedicaid