Provider Demographics
NPI:1134419542
Name:ROBERTS-NEW, MELISSA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:
Last Name:ROBERTS-NEW
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5324 WIRESTEM CT
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-5344
Mailing Address - Country:US
Mailing Address - Phone:331-457-5260
Mailing Address - Fax:
Practice Address - Street 1:29 S WEBSTER ST STE 240
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-5356
Practice Address - Country:US
Practice Address - Phone:331-457-5260
Practice Address - Fax:331-213-9039
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-19
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0122431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical