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General NPI Number Information
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NPI Number | 1821228362
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Entity Type | Organization
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Legal Business Name | MELINDA DWORKIN & ASSOCIATES INC.
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Dates
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Enumeration Date | 07/17/2009
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Last Update Date | 08/04/2009
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Provider Practice Location Address
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Address Line | 1609 SHERMAN AVE SUITE 300
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City | EVANSTON
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State | IL
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Zip | 60201-3753
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Country | US
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Telephone | 847-475-0451
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Fax | 847-475-4849
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Provider Business Mailing Address
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Address Line | 1617 BRUMMEL ST
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City | EVANSTON
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State | IL
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Zip | 60202-3709
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Country | US
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Telephone | 847-475-0451
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Fax | 847-475-4849
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. MELINDA DWORKIN
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Credential | LCSW
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Telephone | 847-475-0451
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149.011855
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License Number State | IL
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