Titus Shane Mayberry, LPC, MA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

118627 Issued in IA

Practice address

1905 Stadium Blvd
Jefferson City, MO 65109

Phone

(888) 403-1071

NPI assigned

Jul 30, 2018

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Benton Street Counseling LLC

  • Professional Counselor
  • Rolla, MO
  • NPI 1578053955

  Mental Health

  NPD (past)
• Benton Street Counseling LLC

  • Professional Counselor
  • Camdenton, MO
  • NPI 1891229878
  NPD (past)
• Benton Street Counseling LLC

  • Mental Health Counselor
  • Waynesville, MO
  • NPI 1932597721
  NPD (past)
• Cedar Centre Psychiatric Group

  • Psychiatry Physician
  • Cedar Rapids, IA
  • NPI 1558338012

  Mental Health

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1532908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761609600000",
    "number": "1295213619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 COMMUNITY",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647358804",
            "telephone_number": "660-885-8131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 STADIUM BLVD",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "65109",
            "telephone_number": "888-403-1071"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "119 N Benton St",
            "address_purpose": "LOCATION",
            "city": "Waynesville",
            "state": "MO",
            "postal_code": "655832501",
            "country_code": "US",
            "telephone_number": "573-433-2833",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "89 McCrory Dr",
            "address_purpose": "LOCATION",
            "city": "Camdenton",
            "state": "MO",
            "postal_code": "65020",
            "country_code": "US",
            "telephone_number": "573-525-7071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAYBERRY",
        "first_name": "TITUS",
        "middle_name": "SHANE",
        "credential": "LPC, MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-30",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "118627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jack E Matteson, M.D.
• Allyson Nicole Matthesen, PA-C
• Matthew Gassen D.D.S., P.C.
• Andrew Wayne Mauck, LMSW
• Jennifer Maurer
• Lacey Mays, D.C
• Jody Peter McAleer, DPM
• Rhett E McCarty, PSY.D.
• Donna K McCluskey, DO
• Todd D McCluskey, DO

• Mental Health Counselor in Jefferson City, MO
• Providers in Jefferson City, MO by specialty
• Mental Health Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.