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Organization
DERRICK COLLINS LLC
Active
Organization
DERRICK COLLINS LLC
Active
Other names
stress and anxiety center
Organization subpart
No
Provider details
NPI number
Authorized official
DERRICK COLLINS MSW (OWNER)
(386) 262-9852
Entity
Organization
Contact information
Practice address
1615 RIDGEWOOD AVE STE A, HOLLY HILL, FL 32117-1749
(386) 262-9852
Mailing address
19 STARLING DR, DAYTONA BEACH, FL 32117-1886
(386) 262-9852
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
NULL
101YM0800X
Mental Health Counselor
—
—
251B00000X
Case Management Agency
Primary
—
NULL
251S00000X
Community/Behavioral Health Agency
—
NULL
343900000X
Non-emergency Medical Transport (VAN)
—
NULL
Other
Enumeration date
08/09/2021
Last updated
08/09/2021
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