Provider Demographics
NPI:1720728132
Name:MELANIE LERCHEN, PSYCHOTHERAPIST, LCPC, PLLC
Entity Type:Organization
Organization Name:MELANIE LERCHEN, PSYCHOTHERAPIST, LCPC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LERCHEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:206-734-0266
Mailing Address - Street 1:2665 HILLSIDE LN
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-4933
Mailing Address - Country:US
Mailing Address - Phone:206-734-0266
Mailing Address - Fax:
Practice Address - Street 1:1286 N MILWAUKEE AVE # 8
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-9319
Practice Address - Country:US
Practice Address - Phone:206-734-0266
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-01
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty