Provider Demographics
NPI:1023425618
Name:BISCHOFF, SCOTT ERIC (PHD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:ERIC
Last Name:BISCHOFF
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3645 N BRIARWOOD LANE
Mailing Address - Street 2:SUITE A
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-5337
Mailing Address - Country:US
Mailing Address - Phone:765-289-5520
Mailing Address - Fax:765-289-5840
Practice Address - Street 1:3645 N BRIARWOOD LANE
Practice Address - Street 2:SUITE A
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47304-5337
Practice Address - Country:US
Practice Address - Phone:765-289-5520
Practice Address - Fax:765-289-5840
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-16
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39001528A101YM0800X, 103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health