Healthcare Provider Details

I. General information

NPI: 1558962258
Provider Name (Legal Business Name): CHRISTINE MARIE KIRAY PSY.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2020
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 W MAIN ST APT 407
CARMEL IN
46032-3106
US

IV. Provider business mailing address

1130 S CANAL ST STE 1809
CHICAGO IL
60607-5058
US

V. Phone/Fax

Practice location:
  • Phone: 317-362-2746
  • Fax:
Mailing address:
  • Phone: 317-362-2746
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number20043513B
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number071010316
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: