Provider Demographics
NPI:1881760593
Name:REFUGE CHRISTIAN COUNSELING
Entity type:Organization
Organization Name:REFUGE CHRISTIAN COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:R
Authorized Official - Last Name:HOEKSTRA
Authorized Official - Suffix:
Authorized Official - Credentials:MA LCPC
Authorized Official - Phone:708-339-2769
Mailing Address - Street 1:401 E 162ND ST
Mailing Address - Street 2:SUITE 109
Mailing Address - City:SOUTH HOLLAND
Mailing Address - State:IL
Mailing Address - Zip Code:60473-2237
Mailing Address - Country:US
Mailing Address - Phone:708-339-2769
Mailing Address - Fax:708-339-6776
Practice Address - Street 1:401 E 162ND ST
Practice Address - Street 2:SUITE 109
Practice Address - City:SOUTH HOLLAND
Practice Address - State:IL
Practice Address - Zip Code:60473-2237
Practice Address - Country:US
Practice Address - Phone:708-339-2769
Practice Address - Fax:708-339-6776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01635061OtherBCBS OF IL