Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Wild Fern Clinical Therapy PLLC

Organization Clinical Social Worker · NPI 1346084829

Wild Fern Clinical Therapy PLLC provides Clinical Social Worker services 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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