Mr and Ms Mentoring Inc

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MR AND MS MENTORING INC

Practice address

1615 Ridgewood Ave
Holly Hill, FL 32117-1798

Phone

(386) 999-0333

NPI assigned

May 12, 2022

Organization subpart

No

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

Authorized official

Name

Derrick Tariq Collins El, M.S.W

Title

Owner

Phone

(386) 262-9852

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Derrick Collins, M.S.W

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

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

{
    "created_epoch": "1652313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723420800000",
    "number": "1053057935",
    "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",
            "city": "HOLLY HILL",
            "state": "FL",
            "postal_code": "321171798",
            "telephone_number": "386-999-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MR AND MS MENTORING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-12",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A",
        "authorized_official_last_name": "COLLINS EL",
        "authorized_official_first_name": "DERRICK",
        "authorized_official_middle_name": "TARIQ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-262-9852",
        "authorized_official_credential": "M.S.W"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Lauren Mason, PHARM D
• Wendy A McBean
• Beverly Sue McKean, REGISTERED NURSE
• Jackie S Miller, RPH
• Betsy J Morrison, LMT
• Shamiso Mucherera, LAC
• Kelly Frances Murdick, L.M.T.
• Wendy Myers, MD
• Gregory Houston Neely, LMT
• Nemou Medical LLC

• Clinical Social Worker in Holly Hill, FL
• Providers in Holly Hill, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; 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.