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General NPI Number Information
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NPI Number | 1912434366
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Entity Type | Individual
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Provider Name | MELISSA ELIZABETH BURIAN LCSW, CADC
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Gender | Female
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Dates
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Enumeration Date | 05/16/2017
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Last Update Date | 05/16/2017
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Provider Practice Location Address
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Address Line | 143 FIRST ST STE 201
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City | BATAVIA
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State | IL
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Zip | 60510-3102
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Country | US
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Telephone | 815-474-8872
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Fax |
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Provider Business Mailing Address
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Address Line | 1949 MISTY RIDGE LN
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City | AURORA
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State | IL
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Zip | 60503-7333
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Country | US
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Telephone | 815-474-8872
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 32030
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149019212
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License Number State | IL
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