MEDICARE: LAURA BINGHAM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1396104055
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA BINGHAM

Provider Business Mailing Address
First Line	:	PO BOX 70
Second Line	:
City	:	ZELIENOPLE
State	:	PA
Zip	:	16063-0070
Country	:	US
Telephone Number	:	724-452-4453
Fax Number	:

Provider Business Practice Location Address
First Line	:	1601 8TH AVE
Second Line	:
City	:	BEAVER FALLS
State	:	PA
Zip	:	15010-4004
Country	:	US
Telephone Number	:	724-846-5470
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2016
Last Update Date	:	02/23/2016

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Directions to “ LAURA BINGHAM ” Practice Location

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