Provider Demographics
NPI:1588139844
Name:LINNEAR, MELODY (LCSW)
Entity type:Individual
Prefix:
First Name:MELODY
Middle Name:
Last Name:LINNEAR
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 1:1534 HARVEY AVE
Mailing Address - Street 2:
Mailing Address - City:BERWYN
Mailing Address - State:IL
Mailing Address - Zip Code:60402-1411
Mailing Address - Country:US
Mailing Address - Phone:630-788-4585
Mailing Address - Fax:630-929-7570
Practice Address - Street 1:1534 HARVEY AVE
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:IL
Practice Address - Zip Code:60402-1411
Practice Address - Country:US
Practice Address - Phone:630-230-7113
Practice Address - Fax:630-929-7570
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-12
Last Update Date:2024-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0127521041C0700X
101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)