Kathy Medbery, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

000213 Issued in CT

Practice address

50 Beech Mountain Rd
Mansfield Center, CT 06250-1603

Phone

(860) 423-8147

Fax

(860) 423-8147

NPI assigned

Sep 2, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619079399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 BEECH MOUNTAIN RD",
            "city": "MANSFIELD CENTER",
            "state": "CT",
            "postal_code": "062501603",
            "telephone_number": "860-423-8147",
            "fax_number": "860-423-8147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 BEECH MOUNTAIN RD",
            "city": "MANSFIELD CENTER",
            "state": "CT",
            "postal_code": "062501603",
            "telephone_number": "860-423-8147",
            "fax_number": "860-423-8147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDBERY",
        "first_name": "KATHY",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "000213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0007094313",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11243562",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "240000213CT07",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Kinsella-Shaw LLC
• Sonya Mastersen
• Deborah Lee McGeehan, PHD
• Leah McGennis, LMSW
• McLaughlin & Associates L.L.C.
• Rebecca Cricket Medbery, DPT, ATC
• Elena Mercier
• Becky Marie Mineau, RN
• Joseph Mongillo, LPC-A
• Rebecca Moore, MA, LPC

• Professional Counselor in Mansfield Center, CT
• Providers in Mansfield Center, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.