Individual provider Active NPI

Russell Bingham, ACMHC

  • Mental Health Counselor
  • St George, UT
National Provider Identifier
1275923161
Registry record updated Jan 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
5599275-6009 Issued in 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
Last updated
Jan 29, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 5599275-6009 UT Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241127003837 UT Practitioner - Mental Health Counselor 5092240093 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest CenterGroup PAC ID 0941246086, 18 clinicians

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5599275-6009UTMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Center CurrentSince Sep 21, 2024 Accepting new patients
Southwest Center CurrentSince Sep 21, 2024 Accepting new patients
Southwest Center Current Accepting new patients

Locations

474 W 200 N
St George, UT 84770
Phone (435) 634-5660

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

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1422489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422489600000",
    "number": "1275923161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "474 W 200 N",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847704505",
            "telephone_number": "435-634-5600",
            "fax_number": "435-986-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "474 W 200 N",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847704505",
            "telephone_number": "435-634-5600",
            "fax_number": "435-986-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BINGHAM",
        "first_name": "RUSSELL",
        "credential": "ACMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-29",
        "last_updated": "2015-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "5599275-6009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

Verify at the official NPI Registry.