Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 14303 | IL |
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 15348-132 | WI |
N | 101YM0800X | Mental Health Counselor | 15360-135 | WI |
N | 101YP2500X | Professional Counselor | 4047-125 | WI |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 180004694 | IL |
Y | 103TC1900X | Counseling Psychologist | 320657 | WI |
NPI | 1215039201 |
---|---|
Provider Name | Dr. Daniel Wayne Bishop |
First Address | Lake Geneva, WI 53147-1800 |
Second Address | Lake Geneva, WI 53147-1800 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2006 |
Last Update Date | 03/02/2020 |