Individual provider Active NPI

Clarence E Bilbray, LMHC

  • Mental Health Counselor
  • Jacksonville, FL
National Provider Identifier
1801041322
Registry record updated Nov 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH8133 Issued in FL
Practice address
3810-3 Williamsburg Park Blvd
Jacksonville, FL 32257-9220
Phone
(904) 419-6102
NPI assigned
Nov 25, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 25, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH8133 FL Primary

Addresses

Primary practice location

3810-3 Williamsburg Park Blvd
Jacksonville, FL 32257-9220

Mailing address

124 Vanderford Rd N
Orange Park, FL 32073-5968
Phone (904) 215-0063

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

LicenseStateTypeSpecialty
MH8133FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Breakthroughs Counseling and Recovery Inc. Mental Health Past Accepting new patients
Breakthroughs Counseling & Recovery Mental Health PastSince Jul 1, 2024 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1227571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227571200000",
    "number": "1801041322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 VANDERFORD RD N",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735968",
            "telephone_number": "904-215-0063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3810-3 WILLIAMSBURG PARK BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322579220",
            "telephone_number": "904-419-6102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BILBRAY",
        "first_name": "CLARENCE",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-25",
        "last_updated": "2008-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH8133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.