Individual provider Active NPI

Deann Renee Collins, LCSW

  • Clinical Social Worker
  • Melbourne, FL
National Provider Identifier
1215492178
Registry record updated Feb 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW12295 Issued in FL
Practice address
3661 S Babcock St Ste 115
Melbourne, FL 32901-8205
Phone
(321) 434-7604
Fax
(321) 725-1998
NPI assigned
Feb 5, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW12295 FL Primary

Addresses

Primary practice location

3661 S Babcock St Ste 115
Melbourne, FL 32901-8205

Mailing address

328 Anthony Ave SE
Palm Bay, FL 32909-3621
Phone (321) 223-3412

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
SW12295FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Holmes Regional Medical Center, Inc. Past Accepting new patients
Health First Medical Group, LLC Past 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": "1549324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549324800000",
    "number": "1215492178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "328 ANTHONY AVE SE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329093621",
            "telephone_number": "321-223-3412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3661 S BABCOCK ST STE 115",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329018205",
            "telephone_number": "321-434-7604",
            "fax_number": "321-725-1998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "DEANN",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-05",
        "last_updated": "2019-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW12295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2019; 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.