Provider Demographics
NPI:1275859449
Name:HEDLUND NELSON, MELISSA JANE (PHD, ATR-BC, LCPC)
Entity Type:Individual
Prefix:MISS
First Name:MELISSA
Middle Name:JANE
Last Name:HEDLUND NELSON
Suffix:
Gender:F
Credentials:PHD, ATR-BC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24600 W 127TH ST STE B340
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60585-9517
Mailing Address - Country:US
Mailing Address - Phone:815-731-9100
Mailing Address - Fax:815-731-9110
Practice Address - Street 1:24600 W 127TH ST STE B340
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60585-9517
Practice Address - Country:US
Practice Address - Phone:815-731-9100
Practice Address - Fax:815-731-9110
Is Sole Proprietor?:No
Enumeration Date:2010-04-13
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.008048101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional