Daniel Wayne Bishop, PSY.D

Individual provider Active NPI Counseling Psychologist · Delavan, WI

NPI 1215039201 · NPPES record last updated Jul 12, 2024

Key facts

NPI
1215039201
Entity type
Individual (NPI type 1)
Primary specialty
Counseling Psychologist 103TC1900X
License
320657 (WI)
Practice address
312 S 7TH St Stop 2
Delavan, WI 53115-1964
Phone
(262) 374-4444
Fax
(844) 247-2735
NPI assigned
Sep 1, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20160809000902 WI Practitioner - Clinical Psychologist 3072836360

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
14303ILMDAddiction (Substance Use Disorder) Counselor
15348-132WIMDAddiction (Substance Use Disorder) Counselor
15360-135WIMDMental Health Counselor
4047-125WIMDProfessional Counselor
180004694ILMDCognitive & Behavioral Psychologist
320657WIMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
American Behavioral Clinics, SC Past Accepting new patients
Credence Therapy Associates Inc Past
since Aug 3, 2011
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 15360-135 WI
Addiction (Substance Use Disorder) Counselor 101YA0400X 15348-132 WI
Professional Counselor 101YP2500X 4047-125 WI
Addiction (Substance Use Disorder) Counselor 101YA0400X 14303 IL
Psychologist 103T00000X
Cognitive & Behavioral Psychologist 103TB0200X 180004694 IL
Counseling Psychologist 103TC1900X 320657 WI Yes

Addresses

Primary practice location

312 S 7TH St Stop 2
Delavan, WI 53115-1964

Mailing address

191 W South St
Lake Geneva, WI 53147-2417
Phone (262) 374-3445

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address dan@bishopcounseling.org Direct

Other providers in Delavan, WI

All providers in Delavan, WI · Counseling Psychologist in Wisconsin

Sources for this page

Verify at the official NPI Registry.