Susan Dawn Mayberry

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

2243 Issued in NE

Practice address

801 Harmony St Ste 302
Council Bluffs, IA 51503-3106

Phone

(712) 328-2609

NPI assigned

Aug 5, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in IA, NE2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Mental Health Counselor

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alegent Creighton HealthGroup PAC ID 1850285255, shared by 26 NPIs, 137 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Alegent Creighton Health

  dba CHI Health Psychiatric Associates

  • Psychiatry Physician
  • Council Bluffs, IA
  • NPI 1770922437

  Mental Health

  Medicare reassignment NPD
• Alegent Creighton Health

  dba CHI Health

  • Internal Medicine Physician
  • Omaha, NE
  • NPI 1033288923
  Medicare reassignment NPD
• Self

  • Community/Behavioral Health Agency
  • Glenwood, IA
  • NPI 1508319666
  NPD (past) Authorized official
• Alegent Creighton Health

  dba CHI Health

  • Community/Retail Pharmacy
  • Lincoln, NE
  • NPI 1598423220
  NPD

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

{
    "created_epoch": "1470355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699920000000",
    "number": "1861946071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 VALLEY ST",
            "city": "GLENWOOD",
            "state": "IA",
            "postal_code": "515341024",
            "telephone_number": "712-527-1064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 HARMONY ST STE 302",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515033106",
            "telephone_number": "712-328-2609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYBERRY",
        "first_name": "SUSAN",
        "middle_name": "DAWN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-05",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IA",
            "license": "20R002",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NE",
            "license": "1314",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "099212",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "2243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara Lynn Maxwell, LMSW
• Cody Maxwell
• Kristin M. Maxwell, PA-C
• Riley Kay Maxwell
• May Medical, Inc.
• Latois Nicole Mayfield
• Diane Lyn Mayhew, OTR/L
• Carter Mayotte, RA
• Rachael Marie McAtee
• Joanne Marie McConkey, PHARMD

• Mental Health Counselor in Council Bluffs, IA
• Providers in Council Bluffs, IA by specialty
• Mental Health Counselor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.