Wild Fern Clinical Therapy

LBN: Wild Fern Clinical Therapy
Wild Fern Clinical Therapy is an health care organization with primary practice located at 3620 Wesley Ave , Berwyn IL 60402-3861. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as the primary health care specialty. Wild Fern Clinical Therapy can be contacted via phone (616) 212-8957, or through Johnston Dumerauf, Elise via phone (616) 212-8957.

Contact Information

Primary practice address
3620 Wesley Ave Berwyn IL 60402-3861
Phone: (616) 212-8957
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Johnston Dumerauf, Elise Licensed Clinical Social Worker (LCSW)
Phone: (616) 212-8957

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X

Profile Details

NPI number 1346084829
LBN Legal business name Wild Fern Clinical Therapy
DBA Doing business as
Authorized official Johnston Dumerauf, Elise Licensed Clinical Social Worker (LCSW)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 20th, 2024
Last updated Jun 20th, 2024 - about 5 months ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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