Individual
MELISSA ANN STACKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
4745 MAIN ST STE 207, LISLE, IL 60532-1758
(630) 442-1895
Mailing address
4745 MAIN ST STE 207, LISLE, IL 60532-1758
(630) 442-1895
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
104100000X
Social Worker
Primary
—
IL
104100000X
Social Worker
—
—
Other
Enumeration date
10/20/2021
Last updated
03/25/2026
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