Provider Demographics
NPI:1891891446
Name:BISHOP, HAROLD WILLIAM (LCSW)
Entity Type:Individual
Prefix:MR
First Name:HAROLD
Middle Name:WILLIAM
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 1:210-24TH AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33704-3440
Mailing Address - Country:US
Mailing Address - Phone:727-804-3273
Mailing Address - Fax:
Practice Address - Street 1:210-24TH AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33704-3440
Practice Address - Country:US
Practice Address - Phone:727-804-3273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1851101YA0400X
FLSW00025761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ3428Medicare UPIN
FLZ3428Medicare ID - Type Unspecified