Provider Demographics
NPI:1477820249
Name:MELVILLE, CHRISTINA (NCC, LCPC)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:MELVILLE
Suffix:
Gender:F
Credentials:NCC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1323 BOND ST STE 119
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-2368
Mailing Address - Country:US
Mailing Address - Phone:630-717-9408
Mailing Address - Fax:630-596-8496
Practice Address - Street 1:1323 BOND ST STE 119
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-2368
Practice Address - Country:US
Practice Address - Phone:630-717-9408
Practice Address - Fax:630-596-8496
Is Sole Proprietor?:No
Enumeration Date:2011-11-22
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.006994101YP2500X
IL180008607101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional