Provider Demographics
NPI:1912937756
Name:REFSELL, KATHRYN JEAN (MSW LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:JEAN
Last Name:REFSELL
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:MISS
Other - First Name:KATHRYN
Other - Middle Name:JEAN
Other - Last Name:FRITZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:N84W19587 MENOMONEE AVE
Mailing Address - Street 2:ALLIED MENTAL HEALTH REHAB CLINICS
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-1826
Mailing Address - Country:US
Mailing Address - Phone:262-255-4178
Mailing Address - Fax:262-255-4448
Practice Address - Street 1:10125 W NORTH AVE
Practice Address - Street 2:ALLIED MENTAL HEALTH REHAB CLINICS
Practice Address - City:WAUWATORA
Practice Address - State:WI
Practice Address - Zip Code:53226
Practice Address - Country:US
Practice Address - Phone:414-258-7475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2341231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39618900Medicaid