Provider Demographics
NPI:1124750971
Name:BISHOP, MICHELLE (LPC)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:
Last Name:BISHOP
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 WOODLAND SQUARE BLVD
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77384-2211
Mailing Address - Country:US
Mailing Address - Phone:832-365-3515
Mailing Address - Fax:
Practice Address - Street 1:94 SPRING MIST PL
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77381-6138
Practice Address - Country:US
Practice Address - Phone:214-864-2190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-29
Last Update Date:2024-09-06
Deactivation Date:2022-08-30
Deactivation Code:
Reactivation Date:2024-09-04
Provider Licenses
StateLicense IDTaxonomies
TX74883101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional