Provider Demographics
NPI:1538521638
Name:WOOLEVER, MELISSA (LCPC)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:
Last Name:WOOLEVER
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 1:1250 N MILL ST
Mailing Address - Street 2:SUITE 102A
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-6304
Mailing Address - Country:US
Mailing Address - Phone:630-618-0812
Mailing Address - Fax:
Practice Address - Street 1:1250 N MILL ST
Practice Address - Street 2:SUITE 102A
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-6304
Practice Address - Country:US
Practice Address - Phone:630-618-0812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-28
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180010299101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional