Provider Demographics
NPI:1912395658
Name:BINGHAM, JEANA (MSW)
Entity Type:Individual
Prefix:MS
First Name:JEANA
Middle Name:
Last Name:BINGHAM
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 LEGION DR STE 28
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-2716
Mailing Address - Country:US
Mailing Address - Phone:859-276-0533
Mailing Address - Fax:859-277-3653
Practice Address - Street 1:340 LEGION DR STE 28
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-2716
Practice Address - Country:US
Practice Address - Phone:859-276-0533
Practice Address - Fax:859-277-3653
Is Sole Proprietor?:No
Enumeration Date:2015-01-05
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)