MEDICARE: MELISSA A LACHAJEWSKI PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	20043437B	IN
2	103TC0700X	Clinical Psychologist	20043437A	IN
3	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1487061123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA A LACHAJEWSKI PSYD

Provider Business Mailing Address
First Line	:	PO BOX 719094
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60677-9318
Country	:	US
Telephone Number	:	317-777-6435
Fax Number	:	317-777-6644

Provider Business Practice Location Address
First Line	:	6640 INTECH BLVD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46278-2011
Country	:	US
Telephone Number	:	317-274-8812
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2014
Last Update Date	:	02/14/2026

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