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Organization
THIRD WAVE WELLNESS, LLC
Active
Organization
THIRD WAVE WELLNESS, LLC
Active
Parent organization
THIRD WAVE WELLNESS, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
THIRD WAVE WELLNESS, LLC
Authorized official
ELIZABETH BIERBAUM CLARKE LCSW (OWNER / CLINICIAN)
(773) 484-7140
Entity
Organization
Contact information
Practice address
636 CHURCH ST STE 418, EVANSTON, IL 60201-4580
(773) 484-7140
Mailing address
636 CHURCH ST STE 418, EVANSTON, IL 60201-4580
(773) 484-7140
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
02/19/2020
Last updated
02/19/2020
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