Individual
GARY DUANE BINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
2 SPRINGBROOK DR, BIDDEFORD, ME 04005-9443
(207) 282-1500
(207) 282-2581
Mailing address
78 ATLANTIC PL, SOUTH PORTLAND, ME 04106-2316
(207) 661-6654
(207) 842-7773
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CAC5432
ME
101YM0800X
Mental Health Counselor
CC4152
ME
101YP2500X
Professional Counselor
Primary
CC4152
ME
Other
Enumeration date
03/04/2008
Last updated
06/22/2016
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