Individual
BETHANY N JARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
2620 STEWART AVE STE 310, WAUSAU, WI 54401-4162
(715) 848-0525
(715) 848-8665
Mailing address
2620 STEWART AVE STE 310, WAUSAU, WI 54401-4162
(715) 848-0525
(715) 848-8665
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
8642-125
WI
104100000X
Social Worker
4338-226
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4338-226
STATE LICENSE
WI
Enumeration date
06/19/2019
Last updated
06/13/2025
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