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General NPI Number Information
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NPI Number | 1659723765
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Entity Type | Individual
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Provider Name | ASHLEY DOLAN PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 07/13/2016
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Last Update Date | 03/16/2021
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Provider Practice Location Address
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Address Line | 155 N MICHIGAN AVE STE 223
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City | CHICAGO
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State | IL
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Zip | 60601-7511
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Country | US
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Telephone | 773-299-8387
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Fax |
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Provider Business Mailing Address
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Address Line | 186 JORALEMON ST FIFTH FLOOR
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City | BROOKLYN
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State | NY
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Zip | 11201-4356
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Country | US
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Telephone | 718-237-4572
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 071.009424
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 020149
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071009424
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License Number State | IL
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