Amanda Elizabeth Mayberry, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SL06217900 Issued in NJ

Practice address

121 Shelley Dr Ste 2F
Hackettstown, NJ 07840-2530

Phone

(908) 892-6225

NPI assigned

Nov 13, 2018

Sex

Female

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

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.

• Warren County Play Therapy, LLC

  • Clinical Social Worker
  • Hackettstown, NJ
  • NPI 1952156457
  NPD Authorized official
• Omni Health Services Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Phillipsburg, NJ
  • NPI 1285149898
  NPD (past)
• Omni Health Services Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Upper Darby, PA
  • NPI 1831236637
  NPD (past)

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

{
    "created_epoch": "1542067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1326516931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 SHELLEY DR STE 2F",
            "city": "HACKETTSTOWN",
            "state": "NJ",
            "postal_code": "078402530",
            "telephone_number": "908-892-6225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 SHELLEY DR STE 2F",
            "city": "HACKETTSTOWN",
            "state": "NJ",
            "postal_code": "078402530",
            "telephone_number": "908-892-6225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYBERRY",
        "first_name": "AMANDA",
        "middle_name": "ELIZABETH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-13",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SL06217900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matilda Sylvia Mason, M.D
• Daniel Jackson Massey Jr., LPC, LCADC
• James Robert Matteson, MD
• Melissa Matturri
• Michael Matullo
• Deborah Ann McKinley, M.A., LPC
• Kurt McKinley, M.A., LPC
• Kara McMahon-Paul
• Denise Renee McManus
• Medexpress Urgent Care - Northern New Jersey, PC

• Clinical Social Worker in Hackettstown, NJ
• Providers in Hackettstown, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2022; 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.