Wild Fern Clinical Therapy Pllc in Berwyn, IL

Wild Fern Clinical Therapy Pllc is a medicare enrolled mental health clinic (Social Worker - Clinical) in Berwyn, Illinois. The current practice location for Wild Fern Clinical Therapy Pllc is 3620 Wesley Ave, Berwyn, Illinois. For appointments, you can reach them via phone at (616) 212-8957. The mailing address for Wild Fern Clinical Therapy Pllc is 3620 Wesley Ave, Berwyn, Illinois and phone number is (616) 212-8957.

Wild Fern Clinical Therapy Pllc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1346084829. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (616) 212-8957.

Contact Information

	Wild Fern Clinical Therapy Pllc
	3620 Wesley Ave Berwyn IL 60402-3861
	(616) 212-8957
	Not Available

Map and Direction

Mental Health Clinic Profile

Full Name	Wild Fern Clinical Therapy Pllc
Speciality	Social Worker
Location	3620 Wesley Ave, Berwyn, Illinois
Authorized Official Name and Position	Elise Johnston Dumerauf (OWNER)
Authorized Official Contact	6162128957
Accepts Medicare Insurance	Yes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Wild Fern Clinical Therapy Pllc 3620 Wesley Ave Berwyn IL 60402-3861 Ph: (616) 212-8957	Wild Fern Clinical Therapy Pllc 3620 Wesley Ave Berwyn IL 60402-3861 Ph: (616) 212-8957

NPI Details:

NPI Number	1346084829
Provider Enumeration Date	06/20/2024
Last Update Date	08/25/2024
Certification Date	08/25/2024

Medicare PECOS Information:

Medicare PECOS PAC ID	9335689025
Medicare Enrollment ID	O20240909003144

Medical Identifiers

Medical identifiers for Wild Fern Clinical Therapy Pllc such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1346084829	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	(* (Not Available))	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Wild Fern Clinical Therapy Pllc acts as a billing entity for following providers:

Provider Name	Elise Joelle Johnston Dumerauf
Provider Type	Practitioner - Clinical Social Worker
Provider Identifiers	NPI Number: 1508348343 PECOS PAC ID: 2668876533 Enrollment ID: I20210814000200

Reviews and Comments

Social Worker in Berwyn, IL

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Wild Fern Clinical Therapy Pllc - Medicare Mental Health Clinic in Berwyn, IL