Mayberry, Kimberly A

Mayberry, Kimberly A is an individual health care provider with primary practice located at 331 Sijen Ave , Whiteman Afb MO 65305-1269. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Mayberry, Kimberly A can be contacted via phone (660) 687-3143.

Contact Information

Primary practice address
331 Sijen Ave Whiteman Afb MO 65305-1269
Phone: (660) 687-3143
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X 8459 Kansas
Behavioral Health & Social Service Providers / Social Worker 104100000X 2016009943 Missouri
Behavioral Health & Social Service Providers / Clinical 1041C0700X 2017003630 Missouri
Behavioral Health & Social Service Providers / Clinical 1041C0700X 4620 Kansas

Profile Details

NPI number 1992069991
LBN Legal business name Mayberry, Kimberly A
Credentials LSCSW
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 25th, 2012
Last updated Mar 5th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992069991 NPPES
Missouri Other 2017003630 STATE OF MISSOURI DIV OF PROF REGISTRATION STATE COMMITTEE FOR SOCIAL WORKERS
Missouri Other 4620 STATE OF MISSOURI DIV OF PROF REGISTRATION STATE COMMITTEE FOR SOCIAL WORKERS

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