Provider Demographics
NPI:1144405424
Name:MUNDAY, MELISSA L (LCPC CADC)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:L
Last Name:MUNDAY
Suffix:
Gender:F
Credentials:LCPC CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 BLACK RD
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-5942
Mailing Address - Country:US
Mailing Address - Phone:815-774-3273
Mailing Address - Fax:815-727-6688
Practice Address - Street 1:800 BLACK RD
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-5942
Practice Address - Country:US
Practice Address - Phone:815-774-3273
Practice Address - Fax:815-727-6688
Is Sole Proprietor?:No
Enumeration Date:2008-01-04
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL26613101YA0400X
IL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)