Provider Demographics
NPI:1700910551
Name:FRETZIN, KAREN (LCPC, CADC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:FRETZIN
Suffix:
Gender:F
Credentials:LCPC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:778 W FRONTAGE RD
Mailing Address - Street 2:SUITE 113
Mailing Address - City:NORTHFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60093-1209
Mailing Address - Country:US
Mailing Address - Phone:847-784-6953
Mailing Address - Fax:847-784-8068
Practice Address - Street 1:778 W FRONTAGE RD
Practice Address - Street 2:SUITE 113
Practice Address - City:NORTHFIELD
Practice Address - State:IL
Practice Address - Zip Code:60093-1209
Practice Address - Country:US
Practice Address - Phone:847-784-6953
Practice Address - Fax:847-784-8068
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2014-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
IL180002475101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01632368OtherBLUE CROSS