Provider Demographics
NPI:1801685425
Name:WILD IRIS PSYCHOTHERAPY
Entity type:Organization
Organization Name:WILD IRIS PSYCHOTHERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:RACHELLE
Authorized Official - Middle Name:LEAH
Authorized Official - Last Name:DEBEHNKE
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC, CADC
Authorized Official - Phone:773-964-5225
Mailing Address - Street 1:4578 N MEADE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60630-3005
Mailing Address - Country:US
Mailing Address - Phone:773-964-5225
Mailing Address - Fax:
Practice Address - Street 1:4578 N MEADE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60630-3005
Practice Address - Country:US
Practice Address - Phone:773-964-5225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health