Provider Demographics
NPI:1821454661
Name:MELISSA CARAVA, LLC
Entity Type:Organization
Organization Name:MELISSA CARAVA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:M
Authorized Official - Last Name:CARAVA
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:773-717-2620
Mailing Address - Street 1:515 TURICUM RD
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60045-3365
Mailing Address - Country:US
Mailing Address - Phone:773-717-2620
Mailing Address - Fax:
Practice Address - Street 1:222 E WISCONSIN AVE STE 108
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:IL
Practice Address - Zip Code:60045-1700
Practice Address - Country:US
Practice Address - Phone:773-717-2620
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-09
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180010016101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty