Provider Demographics
NPI:1235948084
Name:JEFFERY BISHOP LCSW PLLC
Entity type:Organization
Organization Name:JEFFERY BISHOP LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:D
Authorized Official - Last Name:BISHOP
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:405-808-6522
Mailing Address - Street 1:1330 LINDALE AVE
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-4421
Mailing Address - Country:US
Mailing Address - Phone:405-808-6522
Mailing Address - Fax:405-364-5379
Practice Address - Street 1:2500 MCGEE DR STE 127
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-6705
Practice Address - Country:US
Practice Address - Phone:405-808-6522
Practice Address - Fax:405-364-5379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty