Provider Demographics
NPI:1346528585
Name:GRZESIK-DUFFY, MELANIE (MA, LCPC)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:
Last Name:GRZESIK-DUFFY
Suffix:
Gender:F
Credentials:MA, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9697 191ST ST
Mailing Address - Street 2:
Mailing Address - City:MOKENA
Mailing Address - State:IL
Mailing Address - Zip Code:60448-8609
Mailing Address - Country:US
Mailing Address - Phone:630-646-6540
Mailing Address - Fax:630-646-6542
Practice Address - Street 1:9697 191ST ST
Practice Address - Street 2:
Practice Address - City:MOKENA
Practice Address - State:IL
Practice Address - Zip Code:60448-8609
Practice Address - Country:US
Practice Address - Phone:630-646-6540
Practice Address - Fax:630-646-6542
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-21
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health