Bethany N Jark, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

8642-125 Issued in WI

Practice address

400 Reid St Ste N
De Pere, WI 54115-2164

Phone

(715) 842-9500

Fax

(715) 848-0425

NPI assigned

Jun 19, 2019

Last updated

Jul 7, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Bethany N Krombholz Former name

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Charis Counseling LLCGroup PAC ID 1456244276, 13 clinicians

Behavioral Health Clinic LLCGroup PAC ID 8628409885, 43 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cschroder@chariscounselingwi.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Behavioral Health Clinic, LLC

  • Clinical Psychologist
  • Wausau, WI
  • NPI 1831442359

  Professional

  Medicare reassignment Care Compare group NPD
• Charis Counseling, LLC

  • Professional Counselor
  • Wausau, WI
  • NPI 1427144054
  Medicare reassignment Care Compare group NPD
• Behavioral Health Clinic, LLC

  • Clinical Psychologist
  • Grafton, WI
  • NPI 1902698533

  Professional

  NPD (past)

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

{
    "created_epoch": "1560902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783382400000",
    "number": "1861052078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 REID ST STE N",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541152164",
            "telephone_number": "715-842-9500",
            "fax_number": "715-848-0425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 REID ST STE N",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541152164",
            "telephone_number": "715-842-9500",
            "fax_number": "715-848-0425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARK",
        "first_name": "BETHANY",
        "middle_name": "N",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-19",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "8642-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETHANY",
            "last_name": "KROMBHOLZ",
            "middle_name": "N",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Barbara Isom, PT
• Lori Jean Jacobs, APNP
• Amy Sara Jakubovsky, D.C.
• James G. Fritsche DDS SC
• Amy Ann James, MD
• JB Behavioral Health, LLC
• Jennifer Jeninga-Nehls
• Lori Johansen, PTA
• Andrew Johnson, LPC
• Ashley N Johnson, LPC

• Professional Counselor in De Pere, WI
• Providers in De Pere, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.