Organization Active NPI

Mayberry Mental Wellness LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1649175340
Registry record updated Oct 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
MAYBERRY MENTAL WELLNESS LLC
Practice address
11111 San Jose Blvd # 1105
Jacksonville, FL 32223-7946
Phone
(847) 529-4168
NPI assigned
Oct 12, 2026
Last updated
Oct 12, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2026

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

Authorized official

Name
Dr. Amaris Blanche Mayberry, PMHNP
Title
Owner/Practioner
Phone
(847) 529-4168

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X Primary

Addresses

Primary practice location

11111 San Jose Blvd # 1105
Jacksonville, FL 32223-7946

Mailing address

11111 San Jose Blvd # 1105
Jacksonville, FL 32223-7946
Phone (847) 529-4168

NPI Registry JSON

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

{
    "created_epoch": "1791763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791763200000",
    "number": "1649175340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11111 SAN JOSE BLVD # 1105",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322237946",
            "telephone_number": "847-529-4168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11111 SAN JOSE BLVD # 1105",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322237946",
            "telephone_number": "847-529-4168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYBERRY MENTAL WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-10-12",
        "last_updated": "2026-10-12",
        "certification_date": "2026-10-12",
        "status": "A",
        "authorized_official_last_name": "MAYBERRY",
        "authorized_official_first_name": "AMARIS",
        "authorized_official_middle_name": "BLANCHE",
        "authorized_official_title_or_position": "OWNER/PRACTIONER",
        "authorized_official_telephone_number": "847-529-4168",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.