Russell Bingham, ACMHC
Individual provider Active NPI Mental Health Counselor · St George, UT
NPI 1275923161 · NPPES record last updated Jan 29, 2015
Key facts
- NPI
- 1275923161
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 5599275-6009 (UT)
- Practice address
- 474 W 200 N
St George, UT 84770-4505 - Phone
- (435) 634-5600
- Fax
- (435) 986-8700
- NPI assigned
- Jan 29, 2015
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Southwest Center
Practice addresses (Care Compare)
474 W 200
Suite 300
Saint George, UT 84770-4505
474 W 200 N
300 Southwest Center/Southwest Behavioral H
St George, UT 84770-4505
Phone (435) 634-5600
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241127003837 | UT | Practitioner - Mental Health Counselor | 5092240093 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5599275-6009 | UT | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southwest Center | Current |
Accepting new patients | |
| Southwest Center | Current | Accepting new patients | |
| Southwest Center | Current |
Accepting new patients |
Locations
474 W 200 N
#300
St George, UT 84770
Phone (435) 634-5621
474 W 200 N
Ste 300
St George, UT 84770
Phone (435) 634-5606
474 W 200 N
St George, UT 84770
Phone (435) 634-5660
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 5599275-6009 | UT | Yes |
Addresses
Primary practice location
474 W 200 N
St George, UT 84770-4505
Mailing address
474 W 200 N
St George, UT 84770-4505
Phone (435) 634-5600
Other providers in St George, UT
- Gartee Bills
- Shandi Bills
- Brian Bingham
- Codie Bingham
- Joshua Jared Bingham
- Tyler Michael Bingham
- Biokinetix Physical Therapy, LLC
- Sydney Evelyn Birchall
- Destanie Nicole Bird
- Kristine Bird
All providers in St George, UT · Mental Health Counselor in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 29, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.