Provider Demographics
NPI:1184984221
Name:KINGSLEY, NATALIE (DCLINPSYCH)
Entity type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:
Last Name:KINGSLEY
Suffix:
Gender:F
Credentials:DCLINPSYCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11551 FOREST CENTRAL DR STE 200
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-3966
Mailing Address - Country:US
Mailing Address - Phone:972-630-8889
Mailing Address - Fax:
Practice Address - Street 1:1221 ABRAMS RD
Practice Address - Street 2:SUITE 325
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-5578
Practice Address - Country:US
Practice Address - Phone:972-630-8889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-23
Last Update Date:2018-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36372103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical