Wildlight Therapy

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

WILDLIGHT THERAPY

Practice address

5547 N Ravenswood Ave Ste 407
Chicago, IL 60640-1125

Phone

(908) 358-5802

NPI assigned

May 2, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Adriana Brodyn, PHDNPI 1518387968

Title

Owner

Phone

(908) 358-5802

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Adriana Brodyn, M.A, M.A, L.P.C

  • Counselor
  • Chicago, IL
  • NPI 1518387968
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1682985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682985600000",
    "number": "1396434734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4240 N CLARENDON AVE APT 403N",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606131537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5547 N RAVENSWOOD AVE STE 407",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606401125",
            "telephone_number": "908-358-5802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILDLIGHT THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-02",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A",
        "authorized_official_last_name": "BRODYN",
        "authorized_official_first_name": "ADRIANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "908-358-5802",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clare Tucker Wildes
• Jennifer Wildes
• Wildflower Center for Emotional Health PLLC
• Wildflower Collective Counseling
• Wildflower Way Counseling PLLC
• Ellen Wildman
• Carrie A Wilds, L.AC
• Wildwood Therapy LLC
• Judith Wilen
• Emily Wilensky

• Professional Counselor in Chicago, IL
• Providers in Chicago, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.