Derek Joseph Shairs, RMHCI

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

IMH27054 Issued in FL

Practice address

6817 Southpoint Pkwy Ste 2503
Jacksonville, FL 32216-8200

Phone

(904) 326-0246

NPI assigned

Jan 16, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Coleman Counseling, PLLC

  • Mental Health Counselor
  • Jacksonville, FL
  • NPI 1114740305
  NPD

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

{
    "created_epoch": "1736985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1699586933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13936 SPOONBILL ST N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322241387",
            "telephone_number": "978-888-7392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6817 SOUTHPOINT PKWY STE 2503",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168200",
            "telephone_number": "904-326-0246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAIRS",
        "first_name": "DEREK",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "RMHCI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-16",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH27054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shahla Medical Associates PA
• Sean Shahla, MD
• Shahmed PLLC
• Marwan Elahi Shaikh, MD
• Kamal Abdo Shair, MD
• Andrew Hosam Wasily Shaker, MBBCH
• Elizabeth Anna Shald, PHARM.D.
• Natalie Mixson Shallow, DNP, APRN, FNP-BC
• Mehdi Shamloo, MD
• Shands Jacksonville Medical Center Inc

• Mental Health Counselor in Jacksonville, FL
• Providers in Jacksonville, 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 Jan 16, 2025; 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.