Provider Demographics
NPI:1497148993
Name:HEM, MELISSA VICTORIA (LCSW, PMH-C)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:VICTORIA
Last Name:HEM
Suffix:
Gender:F
Credentials:LCSW, PMH-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 N BATAVIA AVE STE 107
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:IL
Mailing Address - Zip Code:60510-1922
Mailing Address - Country:US
Mailing Address - Phone:630-228-1404
Mailing Address - Fax:
Practice Address - Street 1:11 N BATAVIA AVE STE 107
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:IL
Practice Address - Zip Code:60510-1922
Practice Address - Country:US
Practice Address - Phone:630-228-1404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0248481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL149.024848OtherLICENSED CLINICAL SOCIAL WORKER