| Entity Name: | COOPERATIVE COACHING CONCEPTS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 19 Oct 2009 (15 years ago) |
| Document Number: | L09000100350 |
| FEI/EIN Number | 271202996 |
| Address: | 1968 Bayshore Blvd., DUNEDIN, FL, 34698, US |
| Mail Address: | 686 Roanoke st, DUNEDIN, FL, 34698, US |
| ZIP code: | 34698 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1619493970 | 2017-08-18 | 2017-08-18 | 686 ROANOKE ST, DUNEDIN, FL, 346988421, US | 3607 ALT 19 STE B, PALM HARBOR, FL, 346831412, US | |||||||||||||||||||||||||
|
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| Phone | +1 727-505-2155 |
| Fax | 7277960158 |
Authorized person
| Name | MR. MATTHEW HOWE WELCH |
| Role | OWNER |
| Phone | 7275052155 |
Taxonomy
| Taxonomy Code | 106H00000X - Marriage & Family Therapist |
| License Number | MT2587 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 015005342 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| WELCH MATT H | Agent | 686 Roanoke st, DUNEDIN, FL, 34698 |
| Name | Role | Address |
|---|---|---|
| WELCH MATT H | Managing Member | 686 Roanoke st, DUNEDIN, FL, 34698 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2019-04-23 | 1968 Bayshore Blvd., DUNEDIN, FL 34698 | No data |
| CHANGE OF MAILING ADDRESS | 2013-04-25 | 1968 Bayshore Blvd., DUNEDIN, FL 34698 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2013-04-25 | 686 Roanoke st, DUNEDIN, FL 34698 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-30 |
| ANNUAL REPORT | 2023-04-20 |
| ANNUAL REPORT | 2022-04-29 |
| ANNUAL REPORT | 2021-04-27 |
| ANNUAL REPORT | 2020-06-22 |
| ANNUAL REPORT | 2019-04-23 |
| ANNUAL REPORT | 2018-04-25 |
| ANNUAL REPORT | 2017-03-29 |
| ANNUAL REPORT | 2016-04-27 |
| ANNUAL REPORT | 2015-04-07 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
