Provider Demographics
NPI:1487437877
Name:KAPELLEN, BETHANY (LPC-IT)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:
Last Name:KAPELLEN
Suffix:
Gender:F
Credentials:LPC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 GENEVA WAY
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:WI
Mailing Address - Zip Code:53593-2035
Mailing Address - Country:US
Mailing Address - Phone:608-609-0582
Mailing Address - Fax:
Practice Address - Street 1:307 S PATERSON ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53703-3517
Practice Address - Country:US
Practice Address - Phone:608-535-1095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7572-226101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional