Provider Demographics
NPI:1871043547
Name:BISHOP, JANICE DENISE (LISW)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:DENISE
Last Name:BISHOP
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:DENISE
Other - Last Name:SWAIN-BISHOP
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LISW
Mailing Address - Street 1:311 ALBERT SABIN WAY
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-2838
Mailing Address - Country:US
Mailing Address - Phone:513-558-6512
Mailing Address - Fax:513-558-2701
Practice Address - Street 1:311 ALBERT SABIN WAY
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-2838
Practice Address - Country:US
Practice Address - Phone:513-558-6512
Practice Address - Fax:513-558-2701
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-06
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.1600180-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0204020Medicaid
OH051008OtherLCDC