Healthcare Provider Details

I. General information

NPI: 1982741344
Provider Name (Legal Business Name): VIRGINIA MARIA MEJIA LCSW CADC MISA II
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1275 W ROOSEVELT RD SUITE 114
WEST CHICAGO IL
60185
US

IV. Provider business mailing address

1275 W ROOSEVELT RD SUITE 114
WEST CHICAGO IL
60185
US

V. Phone/Fax

Practice location:
  • Phone: 630-231-3554
  • Fax: 630-231-3828
Mailing address:
  • Phone: 630-231-3554
  • Fax: 630-231-3828

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number13447
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number13447
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: