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
—
—
251B00000X
Case Management Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Enumeration date
08/09/2021
Last updated
08/09/2021
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