Provider Demographics
NPI:1710226261
Name:MELINDA LUPFER YACHNIN LCPC INC.
Entity Type:Organization
Organization Name:MELINDA LUPFER YACHNIN LCPC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:LUPFER
Authorized Official - Last Name:YACHNIN
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:312-409-4960
Mailing Address - Street 1:72 S LA GRANGE RD STE 6
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE
Mailing Address - State:IL
Mailing Address - Zip Code:60525-6318
Mailing Address - Country:US
Mailing Address - Phone:312-409-4960
Mailing Address - Fax:
Practice Address - Street 1:72 S LA GRANGE RD STE 6
Practice Address - Street 2:
Practice Address - City:LA GRANGE
Practice Address - State:IL
Practice Address - Zip Code:60525-6318
Practice Address - Country:US
Practice Address - Phone:312-409-4960
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-04
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180005280101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty