Russia Ja'Von Collins, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH16538

Practice address

833 22ND St S
St Petersburg, FL 33712-2250

Phone

(727) 479-3054

NPI assigned

Mar 10, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Interoperability endpoints

• FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
• Direct secure messaging: rcollins200850@direct.tgh.org

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.

• Tampa General Hospital

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1124558929
  NPD

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

{
    "created_epoch": "1583798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583798400000",
    "number": "1245865294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5802 9TH AVE S",
            "city": "GULFPORT",
            "state": "FL",
            "postal_code": "337072541",
            "telephone_number": "727-479-3054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 22ND ST S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337122250",
            "telephone_number": "727-479-3054"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5802 9th Ave S",
            "address_purpose": "LOCATION",
            "city": "Gulfport",
            "state": "FL",
            "postal_code": "337072541",
            "country_code": "US",
            "telephone_number": "727-479-3054 x72747",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "RUSSIA",
        "middle_name": "JA'VON",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-10",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": "MH16538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED MENTAL HEALTH COUNSELOR",
            "identifier": "MH16538",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Juliet Soscia Collins, M.D.
• Kenneth Christopher Collins, PA-C
• Kimberly Renee Collins, M.D.
• Maureen A Collins, ARNP
• Paul Steven Collins, M.D.
• Evelyn Ann Collis, MT-BC
• Michelle Coloma, RN
• Bianca Isabelle Colon Echevarria
• Dennis Colon, DPT
• Gladys Margarita Colon, BA

• Mental Health Counselor in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2020; 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.