Provider Demographics
NPI:1740821107
Name:BISHOP, LAURA (MA, LCMHC NCC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:BISHOP
Suffix:
Gender:F
Credentials:MA, LCMHC NCC
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:HALE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1612 WINDOWS CT
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-9594
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:110 IOWA LN STE 104
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-4493
Practice Address - Country:US
Practice Address - Phone:919-299-0566
Practice Address - Fax:626-884-4464
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-07
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15193101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health