Provider Demographics
NPI:1811193683
Name:BISHOP, WILLIAM CARLTON (LCSW)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:CARLTON
Last Name:BISHOP
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 LEIV EIRIKSON AVE
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-8401
Mailing Address - Country:US
Mailing Address - Phone:908-874-5125
Mailing Address - Fax:
Practice Address - Street 1:31 CLYDE RD
Practice Address - Street 2:SUITE 201
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-5047
Practice Address - Country:US
Practice Address - Phone:732-672-5123
Practice Address - Fax:732-873-3323
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC001878001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical