Provider Demographics
NPI:1093171274
Name:CARAVA, MELISSA M (LCPC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:M
Last Name:CARAVA
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 1:515 TURICUM RD
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60045-3365
Mailing Address - Country:US
Mailing Address - Phone:773-717-2620
Mailing Address - Fax:
Practice Address - Street 1:222 E WISCONSIN AVE STE 108
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:IL
Practice Address - Zip Code:60045-1700
Practice Address - Country:US
Practice Address - Phone:773-717-2620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-04
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180010016101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional