| Entity Name: | CREATIVE THERAPY ASSOCIATES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 17 Jul 2008 (17 years ago) |
| Document Number: | L08000068951 |
| FEI/EIN Number | 263019558 |
| Address: | 600 MAIN AVE., MINNEOLA, FL, 34715, US |
| Mail Address: | 1138 EVEREST STREET, CLERMONT, FL, 34711, US |
| ZIP code: | 34715 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1821254368 | 2008-08-04 | 2023-04-19 | 1138 EVEREST STREET, CLERMONT, FL, 34711, US | 600 S MAIN AVE, MINNEOLA, FL, 347159578, US | |||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 407-376-9277 |
| Fax | 3212480120 |
| Phone | +1 407-399-8855 |
Authorized person
| Name | CHRISTINE TUZZO HARRIS |
| Role | OWNER/PRESIDENT |
| Phone | 4073769277 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| License Number | MH7529 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| License Number | SW5509 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 000341400 |
| State | FL |
| Issuer | MEDICAID |
| Number | 762109400 |
| State | FL |
| Issuer | MEDICAID |
| Number | 768765600 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HARRIS CHRISTINE T | Agent | 1138 EVEREST STREET, CLERMONT, FL, 34711 |
| Name | Role | Address |
|---|---|---|
| HARRIS CHRISTINE T | Managing Member | 1138 EVEREST STREET, CLERMONT, FL, 34711 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2019-05-24 | 600 MAIN AVE., MINNEOLA, FL 34715 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2010-10-19 | 1138 EVEREST STREET, CLERMONT, FL 34711 | No data |
| REGISTERED AGENT NAME CHANGED | 2010-10-19 | HARRIS, CHRISTINE T | No data |
| CHANGE OF MAILING ADDRESS | 2010-10-19 | 600 MAIN AVE., MINNEOLA, FL 34715 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-08 |
| ANNUAL REPORT | 2023-02-07 |
| ANNUAL REPORT | 2022-03-22 |
| ANNUAL REPORT | 2021-02-18 |
| ANNUAL REPORT | 2020-02-04 |
| ANNUAL REPORT | 2019-03-13 |
| ANNUAL REPORT | 2018-05-22 |
| ANNUAL REPORT | 2017-04-28 |
| ANNUAL REPORT | 2016-04-20 |
| ANNUAL REPORT | 2015-03-31 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
