STEPHANIE L MAYBERRY (NPI# 1013559855) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013559855 |
| Entity Type | Individual |
| Full Name | STEPHANIE L MAYBERRY |
| Other Name | STEPHANIE L KING |
| Credential | LPC |
| Practice Address |
6127 Green Bay Rd Ste 200 Kenosha WI 53142-2929 |
| Practice Telephone | 2626548366 |
| Practice Fax Number | 2628420444 |
| Mailing Telephone | 2626548366 |
| Mailing Fax Number | 2628420444 |
| Enumeration Date | 2019-10-14 |
| Last Update Date | 2020-10-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| N | 101YP2500X |
Counselor Specialization: Professional |
7442-125 | WI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | PROFESSIONAL LICENSE | 7442-125 | 01 |
| Street Address |
6127 GREEN BAY RD STE 200 |
| City | KENOSHA |
| State | WI |
| Zip Code | 53142-2929 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346848454 | Brooke A Bilyk | Counselor | 6127 Green Bay Rd Ste 200, Kenosha, WI 53142-2929 | 2020-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588297816 | Caring Hearts Home Health Care | In Home Supportive Care | 6021-57th Ave, Suite C103, Kenosha, WI 53142 | 2020-02-14 |
| 1144785395 | Michael L Wrzesinski | Counselor | 4109 67th Street, Kenosha, WI 53142 | 2019-02-01 |
| 1720538499 | David Smith | Counselor | 10900 67th Street, Kenosha, WI 53142 | 2016-10-06 |
| 1326404641 | Smile Doctors Ltd | Dentist | 7003 39th Ave, Kenosha, WI 53142 | 2016-01-04 |
| 1225409485 | Antonia Marie Decker | Physician Assistant | 10400 75th St. Ste 204, Kenosha, WI 53142 | 2015-10-14 |
| 1780060582 | Joshua Haas | Pharmacist | 7701 Green Bay Road, Kenosha, IL 53142 | 2015-08-04 |
| 1811379225 | Dana Mary Stout | Registered Nurse | 7401 104th Avenue, Suite 110, Comprehensive Orthopaedics, S.c., Kenosha, WI 53142 | 2015-06-22 |
| 1669815569 | Joshua Knute Elson | Radiology | 6811 118th Ave, Kenosha, WI 53142 | 2013-04-10 |
| 1356610166 | Michael J Gallo | Pharmacist | 7535 North Greenbay Rd, Kenosha, WI 53142 | 2011-12-22 |
| 1720357999 | Orest Carnevale | Registered Nurse | 7316 155th Ct, Kenosha, WI 53142 | 2011-12-18 |
| Find all providers in zip 53142 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073110631 | Be Insightful Counseling LLC | Counselor | 2901 35th St Lowr Suiteb, Kenosha, WI 53140-5117 | 2020-10-07 |
| 1144616277 | Kimberly Ann Oleksak | Counselor | 3200 Sheridan Rd Ste 104, Kenosha, WI 53140-1921 | 2015-04-15 |
| 1861428674 | Sharon Lynn O'brien | Counselor | 6121 Green Bay Rd, Suite 220, Kenosha, WI 53142-2926 | 2006-06-23 |
| 1346848454 | Brooke A Bilyk | Counselor | 6127 Green Bay Rd Ste 200, Kenosha, WI 53142-2929 | 2020-10-12 |
| 1043833270 | Linda Flahive | Counselor | 6809 122nd Ave, Kenosha, WI 53142-7335 | 2020-05-21 |
| 1780164707 | Nicole Cremona | Counselor | 2108 63rd St, Kenosha, WI 53143-4454 | 2018-08-20 |
| 1013411693 | Ann M Grossman | Counselor | 6321 23rd Ave, Kenosha, WI 53143-4801 | 2018-03-20 |
| 1902349699 | Monica Nanul | Counselor | 2108-63 Street, Kenosha, WI 53143-4454 | 2016-11-29 |
| 1679970123 | Evette Rowley | Counselor | 2108 63rd St, Kenosha, WI 53143-4454 | 2014-11-28 |
| 1437571056 | Megan Moran | Counselor | 6233 39th Ave, Kenosha, WI 53142-7015 | 2014-01-16 |
| Find all providers in KENOSHA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.