Active NPI
Lanell Mayberry, MFT
- Marriage & Family Therapist
- San Bernardino, CA
National Provider Identifier
1942842349
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 213752
- Practice address
- 165 W Hospitality LN Ste 27
San Bernardino, CA 92408-3326 - Phone
- (760) 241-6044
- Fax
- (760) 820-2704
- NPI assigned
- Oct 17, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 213752 | CA | Primary |
Addresses
Primary practice location
165 W Hospitality LN Ste 27
San Bernardino, CA 92408-3326
Mailing address
PO Box 1292
Helendale, CA 92342-1292
Phone (760) 241-6044
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 213752 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571270400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571270400000",
"number": "1942842349",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1292",
"city": "HELENDALE",
"state": "CA",
"postal_code": "923421292",
"telephone_number": "760-241-6044",
"fax_number": "760-820-2704"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "165 W HOSPITALITY LN STE 27",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924083326",
"telephone_number": "760-241-6044",
"fax_number": "760-820-2704"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAYBERRY",
"first_name": "LANELL",
"name_prefix": "Mrs.",
"credential": "MFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-10-17",
"last_updated": "2019-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "213752",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Bernardino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.