Organization
MELISSA SHANE COUNSELING SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA ANN SHANE LCPC (OWNER)
(309) 369-3498
Entity
Organization
Contact information
Practice address
6919 N KNOXVILLE AVE STE 100, PEORIA, IL 61614-2858
(309) 369-3498
(309) 966-0266
Mailing address
6919 N KNOXVILLE AVE STE 100, PEORIA, IL 61614-2858
(309) 369-3498
(309) 966-0266
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
180008837
IL
Other
Enumeration date
10/14/2017
Last updated
10/14/2017
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