Kathleen E. Mayberry, ED.M.
Individual provider Active NPI Professional Counselor · Williams, OR
NPI 1083798565 · NPPES record last updated Sep 13, 2023
Key facts
- NPI
- 1083798565
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 440 (CO)
- Practice address
- 1015 Panther Gulch Rd
Williams, OR 97544-9709 - Phone
- (303) 956-5284
- NPI assigned
- Oct 24, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C7447 | OR | MD | Professional Counselor |
| 440 | CO | MD | Marriage & Family Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | C7447 | OR | |
| Professional Counselor | 101YP2500X | 440 | CO | Yes |
Addresses
Primary practice location
1015 Panther Gulch Rd
Williams, OR 97544-9709
Mailing address
1015 Panther Gulch Rd
Williams, OR 97544-9709
Phone (303) 956-5284
Other providers in Williams, OR
- Melissa I Emerson
- Micaela Aster Gauss
- Cassidy Geppert
- Angela Hartley
- Allie Taylor Martin
- Andrea McLaughlin
- Harmony Eden Oltman
- Jacqueline Elaine Rowan
- Morgan K Seip
- Zellene Struble
All providers in Williams, OR · Professional Counselor in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 13, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.