Provider Demographics
NPI:1720375918
Name:BISHOP VINCENT, CATHERINE (LPC)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:BISHOP VINCENT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 E PERCY ST
Mailing Address - Street 2:
Mailing Address - City:INDIANOLA
Mailing Address - State:MS
Mailing Address - Zip Code:38751-2543
Mailing Address - Country:US
Mailing Address - Phone:803-629-0872
Mailing Address - Fax:
Practice Address - Street 1:407 E PERCY ST
Practice Address - Street 2:
Practice Address - City:INDIANOLA
Practice Address - State:MS
Practice Address - Zip Code:38751-2543
Practice Address - Country:US
Practice Address - Phone:803-629-0872
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-07
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1585101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional