Provider Demographics
NPI:1770379182
Name:THE REFUGE: MENTAL HEALTH COUNSELING
Entity type:Organization
Organization Name:THE REFUGE: MENTAL HEALTH COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KARYN
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HORAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:708-715-6922
Mailing Address - Street 1:430 E MISSISSIPPI AVE
Mailing Address - Street 2:
Mailing Address - City:ELWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60421-7002
Mailing Address - Country:US
Mailing Address - Phone:815-318-2010
Mailing Address - Fax:
Practice Address - Street 1:430 E MISSISSIPPI AVE
Practice Address - Street 2:
Practice Address - City:ELWOOD
Practice Address - State:IL
Practice Address - Zip Code:60421-7002
Practice Address - Country:US
Practice Address - Phone:815-318-2010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-15
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1861852188OtherINDIVIDUAL NPI