Individual provider · NPI-1

Theodore Atkins Jr., ED.S.

Counselor, Mental Health · Daytona Beach, FL

NPI number1790646347
StatusActive
Last updated in NPPESNov 22, 2025

Details

NPI
1790646347
Entity type
Individual (NPI-1)
Name
Prof. Theodore Atkins Jr.
Credential
ED.S.
Sex
Male
Sole proprietor
Yes
Enumeration date
Nov 22, 2025
Certification date
Nov 22, 2025
Last updated
Nov 22, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YM0800X Counselor, Mental HealthIMH28657FLYes

Practice location

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

Phone 386-747-6541 · Fax 866-401-6150

Mailing address

6631 Gentle Oaks Dr E
Jacksonville, FL 32244-3662

Phone 850-727-6758

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