Provider Demographics
NPI:1952708281
Name:BINGHAM, SHARON J (LMFT)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:J
Last Name:BINGHAM
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3442 S 575 W APT C
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-8040
Mailing Address - Country:US
Mailing Address - Phone:385-439-9327
Mailing Address - Fax:
Practice Address - Street 1:5974 FASHION POINT DR
Practice Address - Street 2:SUITE # 220
Practice Address - City:SOUTH OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-4699
Practice Address - Country:US
Practice Address - Phone:385-439-9327
Practice Address - Fax:801-476-8887
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-02
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT291773-3902106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist