Paul G Binks, PHD

Individual provider Active NPI Clinical Psychologist · South Jordan, UT

NPI 1821037359 · NPPES record last updated Jul 22, 2009

Key facts

NPI
1821037359
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Psychologist 103TC0700X
License
6301010097 (MI)
Practice address
2888 Rock Creek Dr
South Jordan, UT 84095-7946
Phone
(801) 502-9552
Fax
(801) 253-8094
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

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

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6301010097MIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Behavioral Care, Inc. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 5897985-2501 UT
Clinical Psychologist 103TC0700X 6301010097 MI Yes

Addresses

Primary practice location

2888 Rock Creek Dr
South Jordan, UT 84095-7946

Mailing address

2888 Rock Creek Dr
South Jordan, UT 84095-7946
Phone (801) 502-9552

Other providers in South Jordan, UT

All providers in South Jordan, UT · Clinical Psychologist in Utah

Sources for this page

Verify at the official NPI Registry.