Provider Demographics
NPI:1982238119
Name:A. BINGHAM COUNSELING LLC
Entity Type:Organization
Organization Name:A. BINGHAM COUNSELING LLC
Other - Org Name:THE COUNSELING COLLABORATIVE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AUSTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:EDS, LPC
Authorized Official - Phone:678-664-3434
Mailing Address - Street 1:1109 S PARK ST STE 504367
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:GA
Mailing Address - Zip Code:30117-4462
Mailing Address - Country:US
Mailing Address - Phone:678-664-3434
Mailing Address - Fax:
Practice Address - Street 1:1109 S PARK ST STE 504367
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:GA
Practice Address - Zip Code:30117-4462
Practice Address - Country:US
Practice Address - Phone:678-664-3434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-26
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty