Active NPI 1083798565 Individual Practitioner Female Practitioner

Kathleen E. Mayberry , EDM

Counselor - Professional • Williams, OR

Professional Overview & Biography Verified Profile Summary

Kathleen Mayberry, EDM is a registered healthcare professional specializing in Counselor - Professional in Williams, OR. Practice services are available at 1015 PANTHER GULCH RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1015 Panther Gulch Rd

Williams, OR 975449709

Telephone 3039565284

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Williams, OR

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 10.5 Yrs

State Avg: 13.7 Yrs

Regional Practice Density

1 Specialists

Practicing in Williams, OR (2601 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2023-09-13

Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License CO 440

Definition to come...

Counselor - Professional

NUCC Taxonomy Code: 101YP2500X

State License OR C7447

Definition to come...

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

12 Historical Events

📍

Updated Practice Location September 13, 2023

Registered at 1015 PANTHER GULCH RD, WILLIAMS, OR 975449709 (Tel: 3039565284)

📍

Updated Business Mailing Address September 13, 2023

Registered at 1015 PANTHER GULCH RD, WILLIAMS, OR 975449709 (Tel: 3039565284)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) September 13, 2023

Counselor (License #C7447 in OR)

📍

Updated Practice Location August 08, 2023

Registered at 5377 MANHATTAN CIR STE 201, BOULDER, CO 803034345 (Tel: 3039565284)

📍

Updated Business Mailing Address August 08, 2023

Registered at 5377 MANHATTAN CIR STE 201, BOULDER, CO 803034345 (Tel: 3039565284)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) August 08, 2023

Counselor (License #440 in CO)

✅

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍

Updated Practice Location July 08, 2007

Registered at 4770 BASELINE RD STE 310, BOULDER, CO 803032669 (Tel: 3039565284)

📍

Updated Business Mailing Address July 08, 2007

Registered at 4770 BASELINE RD STE 310, BOULDER, CO 803032669 (Tel: 3039565284)

👤

Provider Name / Credentials Updated July 08, 2007

Recorded as KATHLEEN MAYBERRY, ED.M.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Counselor (License #440 in CO)

🟢

Initial NPI Registration & Enumeration October 24, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1083798565

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: October 24, 2006

Last Update: September 13, 2023

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

1015 Panther Gulch Rd

Williams, OR 975449709

Phone: 3039565284

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.