Provider Demographics
NPI:1902377641
Name:BINGHAM, DAVID ALLEN JR (LMHC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:ALLEN
Last Name:BINGHAM
Suffix:JR
Gender:
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 CELEBRATION BLVD STE 405
Mailing Address - Street 2:
Mailing Address - City:CELEBRATION
Mailing Address - State:FL
Mailing Address - Zip Code:34747-5165
Mailing Address - Country:US
Mailing Address - Phone:833-769-3524
Mailing Address - Fax:
Practice Address - Street 1:1530 CELEBRATION BLVD STE 405
Practice Address - Street 2:
Practice Address - City:CELEBRATION
Practice Address - State:FL
Practice Address - Zip Code:34747-5165
Practice Address - Country:US
Practice Address - Phone:833-769-3524
Practice Address - Fax:321-233-9959
Is Sole Proprietor?:No
Enumeration Date:2018-12-06
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH23984101YM0800X
MALMHC11533101YM0800X
VT068.0118746101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health