MEDICARE: GARDEN HEALTH GROUP LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	103TC2200X	Clinical Child & Adolescent Psychologist
2	103TF0000X	Family Psychologist
3	103TP2701X	Group Psychotherapy Psychologist
4	1041C0700X	Clinical Social Worker
5	106H00000X	Marriage & Family Therapist
6	101YA0400X	Addiction (Substance Use Disorder) Counselor
7	101YM0800X	Mental Health Counselor
8	101YP2500X	Professional Counselor
9	103TC1900X	Counseling Psychologist
10	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1639975881
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GARDEN HEALTH GROUP LLC

Provider Business Mailing Address
First Line	:	1219 N TAYLOR AVE
Second Line	:
City	:	OAK PARK
State	:	IL
Zip	:	60302-1147
Country	:	US
Telephone Number	:	818-298-1828
Fax Number	:

Provider Business Practice Location Address
First Line	:	414 CLINTON PLACE
Second Line	:	SUITE 106
City	:	RIVER FOREST
State	:	IL
Zip	:	60305-2248
Country	:	US
Telephone Number	:	708-866-6766
Fax Number	:	708-292-4518

Authorized Official
Title or Position	:	OWNER, DIRECTOR
Name	:	DR. HEATHER L. CORWIN
Credential	:	PHD
Telephone Number	:	818-298-1828

Provider Enumeration Date	:	02/19/2025
Last Update Date	:	03/20/2025

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Directions to “GARDEN HEALTH GROUP LLC ” Practice Location

Language	Start Address	Practice Location

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