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RICHARD W. BISHOP MA, LAC

Addiction (Substance Use Disorder) >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1285265694

Individual Registrant:
 RICHARD W. BISHOP MA, LAC
Gender: M
Not Sole Proprietor

Location and contact information for practice:
811 MAIN CT  CARBONDALE, CO 81623-1851 US
Tel: 970-704-9292  Fax: --

Contact information for business:
PO BOX 1803  CARBONDALE, CO 81623-4803 US
Tel: 850-572-3178  Fax: --

Registration Information:
NPI: 1285265694
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)
COACD.0001428

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
COLORADO STATE LICENSED ADDICTION COUNSELORACD.0001428CO01




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