Provider Demographics
NPI:1285293589
Name:REFUGE THERAPY AND COUNSELING LICENSED CLINICAL SOCIAL WORKER INC.
Entity type:Organization
Organization Name:REFUGE THERAPY AND COUNSELING LICENSED CLINICAL SOCIAL WORKER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:CAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRISTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-284-7761
Mailing Address - Street 1:2037 W BULLARD AVE # 166
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-1200
Mailing Address - Country:US
Mailing Address - Phone:559-284-7761
Mailing Address - Fax:
Practice Address - Street 1:5528 N PALM AVE STE 114
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704-1947
Practice Address - Country:US
Practice Address - Phone:559-284-7761
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-10
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty