Mrs Lisa Reisdorf Bishop, | |
165 Southpark Blvd, St Augustine, FL 32086-4101 | |
(904) 824-7597 | |
Not Available |
Full Name | Mrs Lisa Reisdorf Bishop |
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Gender | Female |
Speciality | Counselor - Mental Health |
Location | 165 Southpark Blvd, St Augustine, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1235166539 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | MH 7777 (Florida) | Primary |
Entity Name | Thriveworks Clinical - Florida Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1396360996 PECOS PAC ID: 5496173577 Enrollment ID: O20200922002675 |
Mailing Address | Practice Location Address |
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Mrs Lisa Reisdorf Bishop, 508 12th St, St Augustine, FL 32084-1462 Ph: (904) 687-0581 | Mrs Lisa Reisdorf Bishop, 165 Southpark Blvd, St Augustine, FL 32086-4101 Ph: (904) 824-7597 |
Daniela Treatment Panet Raymond, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3574 Us 1 S, St Augustine, FL 32086 Phone: 904-217-7161 | |
Kathleen Mary Delucia, CAP Counselor Medicare: Not Enrolled in Medicare Practice Location: 3574 Us Highway 1 S Ste 101-104, St Augustine, FL 32086 Phone: 904-217-7161 Fax: 904-217-4075 | |
Jane G Koike, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 248 Southpark Cir E, St Augustine, FL 32086 Phone: 904-797-5680 Fax: 904-797-5681 | |
Melanie Leigh Weis, PHD Counselor Medicare: Not Enrolled in Medicare Practice Location: 3574 Us 1 S, St Augustine, FL 32086 Phone: 904-417-7100 | |
Dr. Nancy Frances Bent, ED.D. Counselor Medicare: Not Enrolled in Medicare Practice Location: 340 Paseo Reyes Dr, St Augustine, FL 32095 Phone: 904-318-6109 | |
Arielle Hobbs, LMHC INTERN Counselor Medicare: Not Enrolled in Medicare Practice Location: 248 Southpark Cir E, St Augustine, FL 32086 Phone: 904-797-5680 | |
Mrs. Christine Marie Livingston, PHD LMHC Counselor Medicare: Medicare Enrolled Practice Location: 196 Sawmill Forest Ct, St Augustine, FL 32086 Phone: 603-986-7589 |