Provider Demographics
NPI:1578129870
Name:KINGSLEY, ALANA JULIA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ALANA
Middle Name:JULIA
Last Name:KINGSLEY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 E SUPERIOR ST STE 506
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2593
Mailing Address - Country:US
Mailing Address - Phone:847-337-6563
Mailing Address - Fax:
Practice Address - Street 1:1 E SUPERIOR ST STE 506
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2593
Practice Address - Country:US
Practice Address - Phone:847-337-6563
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-13
Last Update Date:2019-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071009443103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical