Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kelly Anne Mayberry

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1841080421

Kelly Anne Mayberry is an Addiction (Substance Use Disorder) Counselor in Massapequa, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2025
Specialties on file
2
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Practice location Address checks out

170A N Oak St
Massapequa, NY 11758-3047
Phone: (516) 404-8692
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence 016025 (NY)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 38714 (NY)

Record details

NPI number1841080421
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMay 8, 2025
Last updated in NPPESMay 8, 2025
Certification dateMay 6, 2025

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