Provider Demographics
NPI:1407569320
Name:HEMZACEK, MELISSA (LCSW)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:HEMZACEK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3610 ROANOKE AVE
Mailing Address - Street 2:
Mailing Address - City:CARPENTERSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60110-3610
Mailing Address - Country:US
Mailing Address - Phone:847-638-1669
Mailing Address - Fax:
Practice Address - Street 1:1655 N ARLINGTON HEIGHTS RD STE 301E
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-3978
Practice Address - Country:US
Practice Address - Phone:847-670-0880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-05
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0249411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical