Individual provider Active NPI

Bethany Anne Romashov, LMHC

  • Mental Health Counselor
  • Bloomington, IN
National Provider Identifier
1235066648
Registry record updated May 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
39005982A Issued in IN
Practice address
4307 S Leonard Springs Rd
Bloomington, IN 47403-4078
Phone
(812) 223-7186
NPI assigned
May 7, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 39005982A IN Primary

Addresses

Primary practice location

4307 S Leonard Springs Rd
Bloomington, IN 47403-4078

Mailing address

3802 S Bushmill Dr
Bloomington, IN 47403-8944
Phone (812) 606-1495

Other practice location 1

120 W 7th St Ste 310
Bloomington, IN 47404-3868
Phone (812) 223-7186

Other names 1

  • Bethany Anne Braley Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
39005982AINMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1778112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778716800000",
    "number": "1235066648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3802 S BUSHMILL DR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474038944",
            "telephone_number": "812-606-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4307 S LEONARD SPRINGS RD",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474034078",
            "telephone_number": "812-223-7186"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 W 7th St Ste 310",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IN",
            "postal_code": "474043868",
            "country_code": "US",
            "telephone_number": "812-223-7186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROMASHOV",
        "first_name": "BETHANY",
        "middle_name": "ANNE",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-05-07",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39005982A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETHANY",
            "last_name": "BRALEY",
            "middle_name": "ANNE",
            "credential": "PHD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bloomington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2026; 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.