Active NPI
Clarence Lee Pitre
- Clinical Social Worker
- Jacksonville, NC
National Provider Identifier
1235745845
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- P014939
- Practice address
- 3886 Henderson Dr
Jacksonville, NC 28546-5219 - Phone
- (910) 938-9833
- NPI assigned
- Sep 18, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | P014939 | NC | |
| Clinical Social Worker | 1041C0700X | P014939 | NC | Primary |
Addresses
Primary practice location
3886 Henderson Dr
Jacksonville, NC 28546-5219
Mailing address
3886 Henderson Dr
Jacksonville, NC 28546-5219
Phone (910) 938-9833
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P014939 | NC | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602201600000",
"number": "1235745845",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3886 HENDERSON DR",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "285465219",
"telephone_number": "910-938-9833"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3886 HENDERSON DR",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "285465219",
"telephone_number": "910-938-9833"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PITRE",
"first_name": "CLARENCE",
"middle_name": "LEE",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-09-18",
"last_updated": "2020-10-09",
"certification_date": "2020-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "P014939",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "P014939",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.