Healthcare Provider Details

I. General information

NPI: 1700700614
Provider Name (Legal Business Name): ALEENA BEHAVIORAL HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2120 W BALMORAL AVE
CHICAGO IL
60625-1006
US

IV. Provider business mailing address

2120 W BALMORAL AVE
CHICAGO IL
60625-1006
US

V. Phone/Fax

Practice location:
  • Phone: 248-379-5033
  • Fax:
Mailing address:
  • Phone: 248-379-5033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. NICOLE ALANA BISHOP
Title or Position: CO-FOUNDER
Credential: PSYD
Phone: 248-379-5033