Theodore Atkins Jr., ED.S.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

IMH28657 Issued in FL

Practice address

435 S Ridgewood Ave Ste 204C-205
Daytona Beach, FL 32114-4927

Phone

(386) 747-6541

Fax

(866) 401-6150

NPI assigned

Nov 22, 2025

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1763769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763769600000",
    "number": "1790646347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6631 GENTLE OAKS DR E",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322443662",
            "telephone_number": "850-727-6758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 S RIDGEWOOD AVE STE 204C-205",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321144927",
            "telephone_number": "386-747-6541",
            "fax_number": "866-401-6150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATKINS",
        "first_name": "THEODORE",
        "name_prefix": "Prof.",
        "name_suffix": "Jr.",
        "credential": "ED.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-11-22",
        "last_updated": "2025-11-22",
        "certification_date": "2025-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH28657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Daytona Beach, FL
• Providers in Daytona Beach, 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 Nov 22, 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.