WILD FERN CLINICAL THERAPY PLLC
NPI 1346084829
Social Worker - Clinical in Berwyn, IL

Active since June 20, 2024
3620 WESLEY AVE, BERWYN, IL 60402(616) 212-8957 Get Directions Write a Review

NPPES record last updated: August 25, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Aug 25, 2024, Jun 20, 2024 (2 updates tracked since 2024).

  • Organization
  • Social Worker
  • Clinical

About WILD FERN CLINICAL THERAPY PLLC

This page provides the complete NPI Profile along with additional information for Wild Fern Clinical Therapy Pllc, a provider established in Berwyn, Illinois operating as a Social Worker, focusing in clinical . The healthcare provider is registered in the NPI registry with number 1346084829 assigned on June 2024. The practitioner's primary taxonomy code is 1041C0700X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Elise Johnston Dumerauf Lcsw (Owner)

NPI
1346084829 Verify this NPI
Provider Name
WILD FERN CLINICAL THERAPY PLLC
Entity Type
Organization
Location Address
3620 WESLEY AVE BERWYN, IL 60402
Location Phone
(616) 212-8957
Mailing Address
3620 WESLEY AVE BERWYN, IL 60402
Mailing Phone
(616) 212-8957
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
06-20-2024
Last Update Date
08-25-2024
Code Navigator

A clinical social worker like Wild Fern Clinical Therapy Pllc is licensed to diagnose and treat mental, behavioral, and emotional disorders. A clinical social worker helps patients develop strategies to change behavior or cope with difficult situations and refer patients to other resources or services, such as support groups or other mental health professionals.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Social Worker Clinical

Taxonomy Code
1041C0700X
Type
Behavioral Health & Social Service Providers
Taxonomy Description
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

ELISE JOHNSTON DUMERAUF LCSW

Authorized Official Title
OWNER
Authorized Official Phone
(616) 212-8957

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Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Social Worker (Clinical)
3620 WESLEY AVE
BERWYN, IL 60402

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1346084829, enumerated as an "organization" on June 20, 2024.

The provider is located at 3620 WESLEY AVE BERWYN, IL 60402 and the phone number is (616) 212-8957.

Social Worker with taxonomy code 1041C0700X and a focus in Clinical.