Healthcare Provider Details

I. General information

NPI: 1154604825
Provider Name (Legal Business Name): MELISSA QUEEN O'CONNOR LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELISSA ANN QUEEN LCSW

II. Dates (important events)

Enumeration Date: 09/20/2011
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1820 E ROBINHOOD LN
ARLINGTON HEIGHTS IL
60004-4222
US

IV. Provider business mailing address

1820 E ROBINHOOD LN
ARLINGTON HEIGHTS IL
60004-4222
US

V. Phone/Fax

Practice location:
  • Phone: 908-797-8476
  • Fax:
Mailing address:
  • Phone: 908-797-8476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.016625
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.09933231
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: