# DERRICK COLLINS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** stress and anxiety center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013682418
- **Authorized official:** DERRICK COLLINS MSW (OWNER)
- **Authorized official phone:** (386) 262-9852

## Contact information

- **Practice address:** 1615 RIDGEWOOD AVE STE A, HOLLY HILL, FL 32117-1749
- **Practice address phone:** (386) 262-9852
- **Mailing address:** 19 STARLING DR, DAYTONA BEACH, FL 32117-1886
- **Mailing address phone:** (386) 262-9852

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 251B00000X | Case Management Agency | — | NULL | Yes |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 343900000X | Non-emergency Medical Transport (VAN) | — | NULL | — |

## Other

- **Enumeration date:** 08/09/2021
- **Last updated:** 08/09/2021