Dr Thomas William Clyburn Iii, PHD in Bradenton, FL

Dr Thomas William Clyburn Iii, PHD is a medicare enrolled "Counselor - Mental Health" provider in Bradenton, Florida. His current practice location is 318 Old Main St, Suite 21, Bradenton, Florida. You can reach out to his office (for appointments etc.) via phone at (941) 224-3800.

Dr Thomas William Clyburn Iii is licensed to practice in Florida (license number MH7314) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1285879361.

Contact Information

	Dr Thomas William Clyburn Iii, PHD
	318 Old Main St, Suite 21, Bradenton, FL 34205-7819
	(941) 224-3800
	(941) 745-1630

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Thomas William Clyburn Iii
Gender	Male
Speciality	Counselor - Mental Health
Location	318 Old Main St, Bradenton, Florida
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1285879361
Provider Enumeration Date: 12/03/2008
Last Update Date: 12/13/2012

Medicare PECOS Information:

PECOS PAC ID: 9537600101
Enrollment ID: I20240923002708

Medical Identifiers

Medical identifiers for Dr Thomas William Clyburn Iii such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1285879361	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	MH7314 (Florida)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Thomas William Clyburn Iii allows following entities to bill medicare on his behalf.

Entity Name	Center Of Revitalizing Psychiatry, P.c.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1356497960 PECOS PAC ID: 0648239988 Enrollment ID: O20120508000536

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Thomas William Clyburn Iii is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Thomas William Clyburn Iii, PHD 4501 Manatee Ave W # 209, Bradenton, FL 34209-3952 Ph: (941) 224-3800	Dr Thomas William Clyburn Iii, PHD 318 Old Main St, Suite 21, Bradenton, FL 34205-7819 Ph: (941) 224-3800

Reviews and Comments

Counselor in Bradenton, FL

Lisa M Davis, L.M.H.C., PH.D. Counselor Medicare: Not Enrolled in Medicare Practice Location: 351 6th Ave W, Bradenton, FL 34205 Phone: 941-737-8897
Jessica Lynn Gomez, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 9030 58th Dr E, Bradenton, FL 34202 Phone: 941-567-6207
Jennell Vanzant, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3914 9th Ave W, Bradenton, FL 34205 Phone: 941-545-6425
Mrs. Susan Tabicman, Counselor Medicare: Not Enrolled in Medicare Practice Location: 6400 Manatee Ave W, Bradenton, FL 34209 Phone: 941-704-9688
Mr. Nestor Levesque, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 379 6th Ave W, Bradenton, FL 34205 Phone: 941-782-4150 Fax: 941-782-4101
Mrs. Virginia D Whittington, MSW Counselor Medicare: Accepting Medicare Assignments Practice Location: 2328 Manatee Ave W, Bradenton, FL 34205 Phone: 941-708-0896 Fax: 941-747-1696
Ms. Lorraine Ann Emmer, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 379 6th Ave W, Bradenton, FL 34205 Phone: 941-782-4100

Dr Thomas William Clyburn Iii, PHD - Medicare Counselor in Bradenton, FL