Active NPI
Mutale Pauline Bingley, LCSW
- Clinical Social Worker
- Braselton, GA
National Provider Identifier
1295098705
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CSW006221
- Practice address
- 1515 River PL Ste 200
Braselton, GA 30517 - Phone
- (770) 848-6140
- Fax
- (770) 848-6141
- NPI assigned
- Jun 19, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 399 | AK | |
| Clinical Social Worker | 1041C0700X | CSW006221 | GA | Primary |
Addresses
Primary practice location
1515 River PL Ste 200
Braselton, GA 30517
Mailing address
PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420
Other practice location 1
8420 Williwa Cir
Anchorage, AK 99504-4158
Phone (190) 789-1011
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mbingley91708@nghs.gadirect.net | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 399 | AK | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607385600000",
"number": "1295098705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 742616",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303742616",
"telephone_number": "770-219-8420"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1515 RIVER PL STE 200",
"city": "BRASELTON",
"state": "GA",
"postal_code": "30517",
"telephone_number": "770-848-6140",
"fax_number": "770-848-6141"
}
],
"practiceLocations": [
{
"address_1": "8420 Williwa Cir",
"address_purpose": "LOCATION",
"city": "Anchorage",
"state": "AK",
"postal_code": "995044158",
"country_code": "US",
"telephone_number": "190-789-1011",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BINGLEY",
"first_name": "MUTALE",
"middle_name": "PAULINE",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-19",
"last_updated": "2020-12-08",
"certification_date": "2020-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "AK",
"license": "399",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "GA",
"license": "CSW006221",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mbingley91708@nghs.gadirect.net",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1515 River Pl Ste 200",
"city": "Braselton",
"state": "GA",
"country_code": "US",
"postal_code": "30517",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Braselton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.