Provider Demographics
NPI:1831526110
Name:KINGSLEY, DALE E (LMFT)
Entity type:Individual
Prefix:
First Name:DALE
Middle Name:E
Last Name:KINGSLEY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:541 EASTERN POINT RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:GROTON
Mailing Address - State:CT
Mailing Address - Zip Code:06340-5158
Mailing Address - Country:US
Mailing Address - Phone:860-705-3668
Mailing Address - Fax:860-405-1113
Practice Address - Street 1:541 EASTERN POINT RD
Practice Address - Street 2:SUITE 2
Practice Address - City:GROTON
Practice Address - State:CT
Practice Address - Zip Code:06340-5158
Practice Address - Country:US
Practice Address - Phone:860-405-1777
Practice Address - Fax:860-405-1113
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-02
Last Update Date:2020-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001607106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist