Behavioral Health Clinic, LLC

Key facts

NPI

1902698533

Entity type

Organization (NPI type 2)

Primary specialty

Clinical Psychologist 103TC0700X

Legal business name

BEHAVIORAL HEALTH CLINIC, LLC

Practice address

1245 Cheyenne Ave Ste 200
Grafton, WI 53024-9323

Phone

(715) 842-9500

Fax

(715) 848-0425

NPI assigned

May 20, 2025

Organization subpart

No

Authorized official

Name

Charity Dawn Fancher

Title

Operations Administrator

Phone

(715) 842-9500

Corporate family (same tax ID) 2

Organizations that report the same tax identification number in the National Provider Directory.

• Behavioral Health Clinic, LLC Clinical Psychologist · Wausau, WI · NPI 1831442359
  NPD tax ID
• Behavioral Health Clinic, LLC Clinical Psychologist · Alexandria, MN · NPI 1083530778
  NPD tax ID

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kathryn M. Keller, PHD Psychologist · Janesville, WI · NPI 1750541835
  NPD PROFESSIONAL
• Melinda Koch Hearing Instrument Specialist · Schofield, WI · NPI 1992158174
  NPD
• Stacy Marie Stefaniak Luther, PSYD Clinical Psychologist · Wausau, WI · NPI 1649666926
  NPD PROFESSIONAL
• Carly N Maas, LPC Professional Counselor · Wausau, WI · NPI 1336733286
  NPD ADDICTION (SUBSTANCE USE DISORDER)
• Heather Joy Meggers-Wright, PH.D. Clinical Psychologist · Wausau, WI · NPI 1376989962
  NPD CLINICAL
• Faith Olivia Anthony, LPC-IT Mental Health Counselor · De Pere, WI · NPI 1992508154
  NPD (past) MENTAL HEALTH
• Nolan J Campbell, LPC Mental Health Counselor · Eau Claire, WI · NPI 1205426244
  NPD (past) MENTAL HEALTH
• McKenna Margaret Crosby, APSW Social Worker · Madison, WI · NPI 1881474419
  NPD (past) SOCIAL WORKER
• Daphne Christine Deeren, LPC Mental Health Counselor · Merrill, WI · NPI 1417722646
  NPD (past) MENTAL HEALTH
• Olushola Dina, NP Psychiatric/Mental Health Nurse Practitioner · Madison, WI · NPI 1811705262
  NPD (past) PSYCHIATRIC/MENTAL HEALTH
• Alwyn Foster, LPC-IT Mental Health Counselor · Madison, WI · NPI 1730710450
  NPD (past) ADDICTION (SUBSTANCE USE DISORDER)
• Patricia Karen Gumz, LCSW Clinical Social Worker · Wausau, WI · NPI 1558914085
  NPD (past) ADDICTION (SUBSTANCE USE DISORDER)
• Joy Higgins, PSYD Clinical Psychologist · Madison, WI · NPI 1699466870
  NPD (past) CLINICAL
• Kaylee Huberty, SLP Speech-Language Pathologist · Marinette, WI · NPI 1265264220
  NPD (past) SPEECH-LANGUAGE PATHOLOGIST
• Bethany N Jark, LPC Professional Counselor · De Pere, WI · NPI 1861052078
  NPD (past) PROFESSIONAL
• Lauren Elizabeth Knuckey, PHD Clinical Psychologist · Madison, WI · NPI 1043903511
  NPD (past) CLINICAL
• Joy Kolbe-Taylor, LPC-IT Professional Counselor · De Pere, WI · NPI 1548194707
  NPD (past) PROFESSIONAL
• Taylor Nathaleen Krueger, LPC-IT Professional Counselor · Merrill, WI · NPI 1780391987
  NPD (past) MENTAL HEALTH
• Louis Michael Rossetti, PH.D. Speech-Language Pathologist · Wausau, WI · NPI 1457788093
  NPD (past) SPEECH-LANGUAGE PATHOLOGIST
• Veronica Ruiz, RN, APNP Psychiatric/Mental Health Nurse Practitioner · Stevens Point, WI · NPI 1700215506
  NPD (past) PSYCHIATRIC/MENTAL HEALTH
• Shannon Erika Schield Speech-Language Pathologist · Wausau, WI · NPI 1376022624
  NPD (past) SPEECH-LANGUAGE PATHOLOGIST
• Courtney Marie Schmidt, PSYD Clinical Psychologist · Madison, WI · NPI 1548103658
  NPD (past) CLINICAL

National Provider Directory

Tax ID family

Behavioral Health Clinic LLC (3 organizations share this tax ID)

Locations

Specialties & licenses

Addresses

Other names

• Behavioral Health Clinic of Wausau Former legal business name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 16, 2026.

{
    "created_epoch": "1747699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784160000000",
    "number": "1902698533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 S 36TH AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544013930",
            "telephone_number": "715-842-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 CHEYENNE AVE STE 200",
            "city": "GRAFTON",
            "state": "WI",
            "postal_code": "530249323",
            "telephone_number": "715-842-9500",
            "fax_number": "715-848-0425"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2417 Post Rd",
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            "postal_code": "544816132",
            "country_code": "US",
            "telephone_number": "715-842-9500",
            "fax_number": "715-848-0425",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 S Mill St Ste 104",
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            "country_code": "US",
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            "fax_number": "715-848-0425",
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        {
            "address_1": "4706 Cottage Grove Rd Ste 100",
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        {
            "address_1": "1800 Pleasure Island Rd",
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        {
            "address_1": "601 E 3rd St",
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            "country_code": "US",
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        {
            "address_1": "630 S 36th Ave",
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            "country_code": "US",
            "telephone_number": "715-842-9500",
            "fax_number": "715-848-0425",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "245 Regency Ct Ste 200A",
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            "city": "Brookfield",
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            "postal_code": "530456167",
            "country_code": "US",
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            "fax_number": "715-848-0425",
            "country_name": "United States",
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        },
        {
            "address_1": "201 N Main St Ste 409",
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            "city": "Fort Atkinson",
            "state": "WI",
            "postal_code": "535381807",
            "country_code": "US",
            "telephone_number": "715-842-9500",
            "fax_number": "715-848-0425",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "703 N 9th St",
            "address_purpose": "LOCATION",
            "city": "Sheboygan",
            "state": "WI",
            "postal_code": "530814515",
            "country_code": "US",
            "telephone_number": "715-842-9500",
            "fax_number": "715-848-0425",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 Reid St Ste N",
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            "city": "DE Pere",
            "state": "WI",
            "postal_code": "541152164",
            "country_code": "US",
            "telephone_number": "715-842-9500",
            "fax_number": "715-848-0425",
            "country_name": "United States",
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        },
        {
            "address_1": "1324 W Clairemont Ave Ste 3",
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            "city": "Eau Claire",
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            "postal_code": "547016191",
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            "telephone_number": "715-842-9500",
            "fax_number": "715-848-0425",
            "country_name": "United States",
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        },
        {
            "address_1": "2363 S 102nd St Ste 302",
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            "city": "West Allis",
            "state": "WI",
            "postal_code": "532272143",
            "country_code": "US",
            "telephone_number": "715-842-9500",
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            "country_name": "United States",
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        },
        {
            "address_1": "W67N222 Evergreen Blvd Ste 209",
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            "city": "Cedarburg",
            "state": "WI",
            "postal_code": "530122645",
            "country_code": "US",
            "telephone_number": "715-842-9500",
            "fax_number": "715-848-0425",
            "country_name": "United States",
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        },
        {
            "address_1": "207 E Buffalo St Ste 510",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532025898",
            "country_code": "US",
            "telephone_number": "715-842-9500",
            "fax_number": "715-848-0425",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1615 Barton Ave",
            "address_purpose": "LOCATION",
            "city": "West Bend",
            "state": "WI",
            "postal_code": "530902029",
            "country_code": "US",
            "telephone_number": "715-842-9500",
            "fax_number": "715-848-0425",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "530 Grant St",
            "address_purpose": "LOCATION",
            "city": "Wausau",
            "state": "WI",
            "postal_code": "544034738",
            "country_code": "US",
            "telephone_number": "715-842-9500",
            "fax_number": "715-848-0425",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Machmueller St",
            "address_purpose": "LOCATION",
            "city": "Weston",
            "state": "WI",
            "postal_code": "544763811",
            "country_code": "US",
            "telephone_number": "715-842-9500",
            "fax_number": "715-848-0425",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BEHAVIORAL HEALTH CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-20",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A",
        "authorized_official_last_name": "FANCHER",
        "authorized_official_first_name": "CHARITY",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "OPERATIONS ADMINISTRATOR",
        "authorized_official_telephone_number": "715-842-9500"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
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            "license": null,
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Behavioral Health Clinic of Wausau",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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