Healthcare Provider Details

I. General information

NPI: 1487437877
Provider Name (Legal Business Name): BETHANY KAPELLEN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2023
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W VERONA AVE
VERONA WI
53593-1394
US

IV. Provider business mailing address

430 GENEVA WAY
VERONA WI
53593-2035
US

V. Phone/Fax

Practice location:
  • Phone: 608-609-0582
  • Fax:
Mailing address:
  • Phone: 608-609-0582
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number7572-226
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: