Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1316205594 Individual Practitioner Male Practitioner

Mark John Derbas , LPC

Counselor • Kenosha, WI

Professional Overview & Biography Verified Profile Summary

Mark Derbas, LPC is a registered healthcare professional specializing in Counselor in Kenosha, WI. Practice services are available at 8503 75TH ST. under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

8503 75th St.
Suite A

Kenosha, WI 531427620

Telephone 2626549370
Fax 2626549379
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor in Kenosha, WI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 13.3 Yrs
State Avg: 11.6 Yrs
Regional Practice Density
34 Specialists

Practicing in Kenosha, WI (872 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2021-07-19
Counselor Primary Specialty

NUCC Taxonomy Code: 101Y00000X

State License WI 1347-226

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

Secondary Practice Locations

4305 Old Green Bay Rd

Mt Pleasant, WI 534039425

Phone: 2247020429

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

12 Associated Practitioners
Kathryn Aalto , LCSW

Social Worker - Clinical

NPI 1023193737

Licensed Clinical Social Worker

NPI 1093148165
Amy Fockler , MS, LCSW

Social Worker - Clinical

NPI 1104001999

Master of Science, Licensed Clinical Social Worker

Pat Bernacchi , LCSW

Social Worker - Clinical

NPI 1174697460

Licensed Clinical Social Worker

Vicki Bartow , MSW

Social Worker - Clinical

NPI 1356526743

Master of Social Work

Danielle Jackson , LPC

Counselor - Professional

NPI 1578000824

Licensed Professional Counselor

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
👤
Provider Name / Credentials Updated December 12, 2019

Recorded as MARK DERBAS, LPC

NPI Profile Active April 25, 2012

NPI status registered as active in NPPES database

📍
Updated Practice Location April 25, 2012

Registered at 8503 75TH ST., SUITE A, KENOSHA, WI 531427620 (Tel: 2626549370)

📍
Updated Business Mailing Address April 25, 2012

Registered at 8503 75TH ST., SUITE A, KENOSHA, WI 531427620 (Tel: 2626549370)

👤
Provider Name / Credentials Updated April 25, 2012

Recorded as MARK DERBASS, LPC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 25, 2012

Counselor (License #1347-226 in WI)

🟢
Initial NPI Registration & Enumeration April 25, 2012

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1316205594
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 25, 2012
Last Update: July 19, 2021
Sole Proprietor: No

Mailing Address

8503 75th St., Suite A

Kenosha, WI 531427620

Phone: 2626549370

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.