Healthcare Provider Details

I. General information

NPI: 1043130719
Provider Name (Legal Business Name): THE BABY FOLD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

318 SUSAN DR
NORMAL IL
61761-6206
US

IV. Provider business mailing address

108 E WILLOW ST
NORMAL IL
61761-1694
US

V. Phone/Fax

Practice location:
  • Phone: 309-452-1170
  • Fax: 309-451-7269
Mailing address:
  • Phone: 309-452-1170
  • Fax: 309-452-0115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: CLETUS WINKELMANN
Title or Position: PRESIDENT AND CEO
Credential:
Phone: 309-451-7201