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NPI Code Detail

MEDICARE: MR. EDDIE LEE COLLINS JR. LMHC

MEDICARE: MR. EDDIE LEE COLLINS JR. LMHC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorMH-8552FL
2101YM0800XMental Health CounselorMH8552FL
3101YM0800XMental Health CounselorMH 8552FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1700835352
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. EDDIE LEE COLLINS JR. LMHC
Provider Business Mailing Address
First Line : 4143 DAY BRIDGE PL
Second Line :
City : ELLENTON
State : FL
Zip : 34222-7236
Country : US
Telephone Number : 941-348-4059
Fax Number :
Provider Business Practice Location Address
First Line : 1437 S BELCHER RD
Second Line :
City : CLEARWATER
State : FL
Zip : 33764-2829
Country : US
Telephone Number : 727-524-4464
Fax Number : 727-538-7272
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2006
Last Update Date : 01/30/2025

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