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Organization

INSTITUTE FOR THERAPY THROUGH THE ARTS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
FREDERICA MELANIE MALONE LCPC (CLINICAL DIRECTOR)
(847) 425-9708
Entity
Organization

Contact information

Practice address
1316 SHERMAN AVE STE 100, EVANSTON, IL 60201-4361
(847) 425-9708
(847) 448-8337
Mailing address
1316 SHERMAN AVE STE 100, EVANSTON, IL 60201-4361
(847) 425-9708
(847) 448-8337

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
1041C0700X
Clinical Social Worker
221700000X
Art Therapist
225600000X
Dance Therapist
225A00000X
Music Therapist
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00621
BLUE CROSS BLUE SHIELD OF ILLINOIS
IL
01
60054
AETNA
IL
01
BS001
BLUE CROSS BLUE SHIELD OF CALIFORNIA
CA
01
SB870
BLUE CROSS BLUE SHIELD OF RHODE ISLAND
RI
Enumeration date
05/01/2015
Last updated
03/25/2025
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