| Entity Name: | KATHLEEN ANDERSON, LMHC, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 30 Mar 2012 (13 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 05 Feb 2014 (11 years ago) |
| Document Number: | L12000044214 |
| FEI/EIN Number | 455006183 |
| Address: | 6221 Lake Lugano Dr, Jacksonville, FL, 32256, US |
| Mail Address: | 6221 Lake Lugano Dr, Jacksonville, FL, 32256, US |
| ZIP code: | 32256 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1811309925 | 2014-05-22 | 2014-05-22 | 9140 GOLFSIDE DR, SUITE 12N, JACKSONVILLE, FL, 322561881, US | 9140 GOLFSIDE DR, SUITE 12N, JACKSONVILLE, FL, 322561881, US | |||||||||||||||||||||||||
|
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| Phone | +1 904-638-9140 |
| Fax | 9047016249 |
Authorized person
| Name | KATHLEEN ANNE ANDERSON |
| Role | OWNER |
| Phone | 9043277192 |
Taxonomy
| Taxonomy Code | 101YP2500X - Professional Counselor |
| License Number | MH4062 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 003958400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ANDERSON KATHLEEN A | Agent | 6221 Lake Lugano Dr, Jacksonville, FL, 32256 |
| Name | Role | Address |
|---|---|---|
| ANDERSON KATHLEEN A | Officer | 6221 Lake Lugano Dr, JACKSONVILLE, FL, 32256 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2023-01-26 | 6221 Lake Lugano Dr, Jacksonville, FL 32256 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-01-26 | 6221 Lake Lugano Dr, Jacksonville, FL 32256 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-01-12 | 6221 Lake Lugano Dr, Jacksonville, FL 32256 | No data |
| REINSTATEMENT | 2014-02-05 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2014-02-05 | ANDERSON, KATHLEEN A | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2013-09-27 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-02 |
| ANNUAL REPORT | 2023-01-26 |
| ANNUAL REPORT | 2022-01-25 |
| ANNUAL REPORT | 2021-01-12 |
| ANNUAL REPORT | 2020-03-03 |
| ANNUAL REPORT | 2019-03-14 |
| ANNUAL REPORT | 2018-03-01 |
| ANNUAL REPORT | 2017-01-10 |
| ANNUAL REPORT | 2016-03-03 |
| ANNUAL REPORT | 2015-01-07 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
