Individual provider Active NPI

Eddie Lee Collins Jr., LMHC

  • Mental Health Counselor
  • Clearwater, FL
National Provider Identifier
1700835352
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH 8552 Issued in FL
Practice address
1437 S Belcher Rd
Clearwater, FL 33764-2829
Phone
(727) 524-4464
Fax
(727) 538-7272
NPI assigned
May 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X MH-8552 FL
Mental Health Counselor 101YM0800X MH8552 FL
Mental Health Counselor 101YM0800X MH 8552 FL Primary

Addresses

Primary practice location

1437 S Belcher Rd
Clearwater, FL 33764-2829

Mailing address

4143 Day Bridge PL
Ellenton, FL 34222-7236
Phone (941) 348-4059

Other practice location 1

4143 Day Bridge Pl
Ellenton, FL 34222-7236
Phone (941) 348-4059

Other identifiers 2

IdentifierTypeStateIssuer
756291800MedicaidFL
767380900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240406000400 FL Practitioner - Mental Health Counselor 8224476494 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Grow Healthcare Group PAGroup PAC ID 3476961368, 1,045 clinicians

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807
Phone (786) 244-7711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH-8552FLMDAddiction (Substance Use Disorder) Counselor
MH 8552FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mindful Mental Health Services - FL Gulf SW LLC CurrentSince Aug 25, 2024 Accepting new patients
Grow Healthcare Group PA Mental Health CurrentSince Feb 29, 2024 Accepting new patients
180 Counseling Group LLC CurrentSince Dec 2, 2024 Accepting new patients
Boley Centers, Inc. Past Accepting new patients

Locations

2605 72nd Ave E
Unit 583
Ellenton, FL 34222

5350 Gulf of Mexico Dr
Ste 203
Longboat Key, FL 34228
Phone (941) 210-0384

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 4

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": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1700835352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4143 DAY BRIDGE PL",
            "city": "ELLENTON",
            "state": "FL",
            "postal_code": "342227236",
            "telephone_number": "941-348-4059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1437 S BELCHER RD",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337642829",
            "telephone_number": "727-524-4464",
            "fax_number": "727-538-7272"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4143 Day Bridge Pl",
            "address_purpose": "LOCATION",
            "city": "Ellenton",
            "state": "FL",
            "postal_code": "342227236",
            "country_code": "US",
            "telephone_number": "941-348-4059",
            "fax_number": "418-034-2159",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "EDDIE",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "MH-8552",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH8552",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH 8552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "756291800",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "767380900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.