Provider Demographics
NPI:1285946798
Name:DEL ROSARIO, MELISSA LYNN (LPC)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:LYNN
Last Name:DEL ROSARIO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:LYNN
Other - Last Name:GONZALEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:620 S 76TH ST STE 120
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53214-1549
Mailing Address - Country:US
Mailing Address - Phone:414-453-1400
Mailing Address - Fax:
Practice Address - Street 1:620 S 76TH ST STE 120
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53214-1549
Practice Address - Country:US
Practice Address - Phone:414-453-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-13
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.006115104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker