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

Mayo R Funderburg II, LADCA

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1053612192

Mayo R Funderburg II, LADCA is an Addiction (Substance Use Disorder) Counselor in Nantucket, Massachusetts. Practices as a sole proprietor. Licensed in Massachusetts.

Licensed in
MA
In the registry since
2010

Practice location Address checks out

20 Vesper Ln Unit L1
Nantucket, MA 02554-4394
Phone: (508) 228-2689
Fax: (508) 228-3613
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence 2282 (MA)

Record details

NPI number1053612192
Entity typeIndividual (Type 1)
GenderMale
Credentials LADCA
Sole proprietorYes
NPI enumeratedNovember 5, 2010
Last updated in NPPESNovember 5, 2010

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