Active NPI
Courtney Lynn Bish, MSW, LICSW
- Clinical Social Worker
- Saint Clairsville, OH
National Provider Identifier
1609305358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- BP00944974
- Practice address
- 68353 Bannock Rd
Saint Clairsville, OH 43950-9736 - Phone
- (740) 695-7733
- NPI assigned
- Jun 7, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | BP00944974 | WV | |
| Clinical Social Worker | 1041C0700X | 2102880 | OH | |
| Clinical Social Worker | 1041C0700X | BP00944974 | WV | Primary |
| Social Worker | 104100000X | 2102880 | OH |
Addresses
Primary practice location
68353 Bannock Rd
Saint Clairsville, OH 43950-9736
Mailing address
68353 Bannock Rd
Saint Clairsville, OH 43950-9736
Phone (740) 695-7733
Other names 1
- Courtney Lynn Bolton
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240904003350 | OH | Practitioner - Mental Health Counselor | 8527508670 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2102880 | OH | MD | Clinical Social Worker |
| BP00944974 | WV | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeast, Inc | Multi-Specialty | Current | Accepting new patients |
| Southeast, Inc | Current | Accepting new patients |
Locations
16 W Long St
Columbus, OH 43215
68353 Bannock Uniontown Rd
St Clairsvle, OH 43950
Phone (740) 695-9344
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Columbus, OH
- NPI 1932169497
Multi-Specialty, OH
-
- Federally Qualified Health Center (FQHC)
- Mount Gilead, OH
- NPI 1114893203
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683158400000",
"number": "1609305358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "68353 BANNOCK RD",
"city": "SAINT CLAIRSVILLE",
"state": "OH",
"postal_code": "439509736",
"telephone_number": "740-695-7733",
"fax_number": "740-695-7787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "68353 BANNOCK RD",
"city": "SAINT CLAIRSVILLE",
"state": "OH",
"postal_code": "439509736",
"telephone_number": "740-695-7733"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BISH",
"first_name": "COURTNEY",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "MSW, LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-06-07",
"last_updated": "2023-05-04",
"certification_date": "2023-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "WV",
"license": "BP00944974",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OH",
"license": "2102880",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WV",
"license": "BP00944974",
"primary": true
},
{
"code": "104100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker",
"state": "OH",
"license": "2102880",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "COURTNEY",
"last_name": "BOLTON",
"middle_name": "LYNN",
"credential": "MSW,LICSW",
"code": "2",
"type": "Professional Name"
}
]
}
Other providers in Saint Clairsville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.