Provider Demographics
NPI:1023308889
Name:MONDSCHAIN, MELISSA (MS LCPC)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:MONDSCHAIN
Suffix:
Gender:F
Credentials:MS LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 MCHENRY RD # 109
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-1796
Mailing Address - Country:US
Mailing Address - Phone:847-275-1137
Mailing Address - Fax:847-600-4171
Practice Address - Street 1:950 SKOKIE BLVD
Practice Address - Street 2:SUITE #304
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062
Practice Address - Country:US
Practice Address - Phone:847-275-1137
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-13
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178006420101YM0800X
IL1800008390101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health