Provider Demographics
NPI:1124355540
Name:GONSKI, MELISSA BETH (LCPC)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:BETH
Last Name:GONSKI
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1N141 COUNTY FARM RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:WINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60190-2032
Mailing Address - Country:US
Mailing Address - Phone:630-221-1909
Mailing Address - Fax:630-221-0102
Practice Address - Street 1:1N141 COUNTY FARM RD
Practice Address - Street 2:SUITE 120
Practice Address - City:WINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60190-2032
Practice Address - Country:US
Practice Address - Phone:630-221-1909
Practice Address - Fax:630-221-0102
Is Sole Proprietor?:No
Enumeration Date:2009-11-05
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180007313101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional