Provider Demographics
NPI:1518682020
Name:MELNYK, KALYNA (LCPC)
Entity Type:Individual
Prefix:
First Name:KALYNA
Middle Name:
Last Name:MELNYK
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2870 BRISTOL DR APT 207
Mailing Address - Street 2:
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-4268
Mailing Address - Country:US
Mailing Address - Phone:315-725-7616
Mailing Address - Fax:
Practice Address - Street 1:770 LAKE COOK RD STE 320
Practice Address - Street 2:
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-4976
Practice Address - Country:US
Practice Address - Phone:315-725-7616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-06
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.014255101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty