Provider Demographics
NPI:1275829814
Name:BINGHAM, LAUREN W (BCABA)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:W
Last Name:BINGHAM
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 S ROGERS RD
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-1704
Mailing Address - Country:US
Mailing Address - Phone:913-324-3849
Mailing Address - Fax:913-780-3387
Practice Address - Street 1:620 S ROGERS RD
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-1704
Practice Address - Country:US
Practice Address - Phone:913-324-3849
Practice Address - Fax:913-780-3387
Is Sole Proprietor?:No
Enumeration Date:2011-06-22
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst