| Entity Name: | CATALYST FOR CHANGE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 25 Aug 2006 (18 years ago) |
| Date of dissolution: | 14 Sep 2007 (17 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 14 Sep 2007 (17 years ago) |
| Document Number: | L06000084357 |
| Address: | 2101 PARK CENTER DRIVE, SUITE 270, ORLANDO, FL, 32835, US |
| Mail Address: | 4114 SHADE TREE LOOP, APARTMENT 90, ORLANDO, FL, 32810, US |
| ZIP code: | 32835 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1093892671 | 2006-11-01 | 2020-08-22 | 4114 SHADE TREE LOOP, STE 90, ORLANDO, FL, 32810, US | 2101 PARK CENTER DRIVE, SUITE 270, ORLANDO, FL, 32835, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 407-968-6723 |
| Fax | 4072944332 |
| Phone | +1 407-523-1213 |
| Fax | 4075232398 |
Authorized person
| Name | SAMIA HUSNI |
| Role | OWNER REGISTERED AGEWNT |
| Phone | 4079686723 |
Taxonomy
| Taxonomy Code | 103T00000X - Psychologist |
| License Number | PY5826 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS GROUP |
| Number | 21491 |
| State | FL |
| Issuer | BCBS |
| Number | 51415 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HUSNI SAMIA | Agent | 400 ISLAND WAY, CLEARWATER, FL, 33767 |
| Name | Role | Address |
|---|---|---|
| HUSNI SAMIA | Managing Member | 4114 SHADE TREE LOOP APT 90, ORLANDO, FL, 32810 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2007-09-14 | No data | No data |
| Name | Date |
|---|---|
| Florida Limited Liability | 2006-08-25 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
