Derrick Collins LLC

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

DERRICK COLLINS LLC

Doing business as

stress and anxiety center

Practice address

1615 Ridgewood Ave Ste a
Holly Hill, FL 32117-1749

Phone

(386) 262-9852

NPI assigned

Aug 9, 2021

Last updated

Aug 9, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Derrick Collins, MSWNPI 1467856427

Title

Owner

Phone

(386) 262-9852

Specialties & licenses 4

Addresses

Other names 1

• stress and anxiety center Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Derrick Collins, M.S.W

  • Clinical Social Worker
  • Daytona Beach, FL
  • NPI 1467856427

  Mental Health

  NPD Authorized official

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

{
    "created_epoch": "1628467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628467200000",
    "number": "1013682418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 STARLING DR",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321171886",
            "telephone_number": "386-262-9852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 RIDGEWOOD AVE STE A",
            "city": "HOLLY HILL",
            "state": "FL",
            "postal_code": "321171749",
            "telephone_number": "386-262-9852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERRICK COLLINS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-09",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "DERRICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-262-9852",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "stress and anxiety center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessica L Condello, PHARM.D.
• Elizabeth Conquest, ATC
• County of Volusia
• Daytona Neighborhood Alf LLC
• Laurie J Deerfield, DO
• Wayne S Downer, LMT
• Daniel E Drake, PAC
• Brandi Lee Driggers
• Durden Consulting Services of Florida
• Michael Scott Edwards

• Case Management Agency in Holly Hill, FL
• Providers in Holly Hill, FL by specialty
• Case Management Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2021; 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.