Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Wild Fern Clinical Therapy PLLC

Organization Clinical Social Worker · NPI 1346084829

Wild Fern Clinical Therapy PLLC is a Clinical Social Worker in Berwyn, Illinois. Registered with an NPI since 2024.

In the registry since
2024
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3620 Wesley Ave
Berwyn, IL 60402-3861
Phone: (616) 212-8957
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X

Record details

NPI number1346084829
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Elise Johnston Dumerauf — Owner · (616) 212-8957
NPI enumeratedJune 20, 2024
Last updated in NPPESAugust 25, 2024
Certification dateAugust 25, 2024
Mailing address3620 Wesley Ave, Berwyn, IL 60402-3861

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