Individual provider Active NPI

Ashley Dolan, PSY.D.

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1659723765
Registry record updated Mar 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071009424 Issued in IL
Practice address
155 N Michigan Ave Ste 223
Chicago, IL 60601-7511
Phone
(773) 299-8387
NPI assigned
Jul 13, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 071.009424 IL
Clinical Psychologist 103TC0700X 020149 NY
Clinical Psychologist 103TC0700X 071009424 IL Primary

Addresses

Primary practice location

155 N Michigan Ave Ste 223
Chicago, IL 60601-7511

Mailing address

186 Joralemon St
Fifth Floor
Brooklyn, NY 11201-4356
Phone (718) 237-4572

Other practice location 1

186 Joralemon St
fifth floor
Brooklyn, NY 11201-4356
Phone (718) 237-4572

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
071.009424ILMDPsychologist
071009424ILMDClinical Psychologist
020149NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
New Narratives CurrentSince Mar 21, 2021 Accepting new patients

Locations

155 N Michigan Ave
Ste 223
Chicago, IL 60601
Phone (773) 299-8387

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1468368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615852800000",
    "number": "1659723765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "186 JORALEMON ST",
            "address_2": "FIFTH FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112014356",
            "telephone_number": "718-237-4572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 N MICHIGAN AVE STE 223",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606017511",
            "telephone_number": "773-299-8387"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "186 Joralemon St",
            "address_2": "fifth floor",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112014356",
            "country_code": "US",
            "telephone_number": "718-237-4572",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOLAN",
        "first_name": "ASHLEY",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-13",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071.009424",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "020149",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071009424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.