Provider Demographics
NPI:1740556919
Name:BISHOP, PATRICIA JO (LCSW)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:JO
Last Name:BISHOP
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10933 ANCHORAGE CIR
Mailing Address - Street 2:
Mailing Address - City:FARRAGUT
Mailing Address - State:TN
Mailing Address - Zip Code:37934-3908
Mailing Address - Country:US
Mailing Address - Phone:865-203-5091
Mailing Address - Fax:
Practice Address - Street 1:200 PROSPERITY DR STE 220
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4718
Practice Address - Country:US
Practice Address - Phone:480-313-8175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-31
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW00000090021041C0700X
AZLCSW-130221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical