Provider Demographics
NPI:1396097168
Name:JOSEPH, MELISSA ANN (LCSW)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:ANN
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1102
Mailing Address - Street 2:
Mailing Address - City:SUGAR GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60554-1102
Mailing Address - Country:US
Mailing Address - Phone:630-306-9990
Mailing Address - Fax:
Practice Address - Street 1:263 MAIN ST
Practice Address - Street 2:
Practice Address - City:SUGAR GROVE
Practice Address - State:IL
Practice Address - Zip Code:60554-5491
Practice Address - Country:US
Practice Address - Phone:630-306-9990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-03
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker