Provider Demographics
NPI:1699111377
Name:O'DONNELL, MELISSA J (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:J
Last Name:O'DONNELL
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 1:4001 W DAYTON ST
Mailing Address - Street 2:
Mailing Address - City:MCHENRY
Mailing Address - State:IL
Mailing Address - Zip Code:60050-8377
Mailing Address - Country:US
Mailing Address - Phone:815-759-7291
Mailing Address - Fax:
Practice Address - Street 1:2306 WOODOAK CIR
Practice Address - Street 2:
Practice Address - City:ROUND LAKE BEACH
Practice Address - State:IL
Practice Address - Zip Code:60073-4144
Practice Address - Country:US
Practice Address - Phone:815-403-9188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-21
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker