Healthcare Provider Details

I. General information

NPI: 1033133616
Provider Name (Legal Business Name): BREAKTHROUGHS COUNSELING & RECOVERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3810-3 WILLIAMSBURG PARK BLVD
JACKSONVILLE FL
32257
US

IV. Provider business mailing address

3810-3 WILLIAMSBURG PARK BLVD
JACKSONVILLE FL
32257
US

V. Phone/Fax

Practice location:
  • Phone: 904-419-6102
  • Fax: 904-739-2153
Mailing address:
  • Phone: 904-419-6102
  • Fax: 904-739-2153

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number0416AD834400
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW1793
License Number StateFL

VIII. Authorized Official

Name: JACQUELINE ELIZABETH IREY
Title or Position: CLINICAL DIRECTOR
Credential: LMHC
Phone: 904-419-6102