| Entity Name: | FAMILY COUNSELING & PSYCHOLOGICAL SERVICES "LLC" |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 20 Apr 2012 (13 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 03 Dec 2012 (12 years ago) |
| Document Number: | L12000053968 |
| FEI/EIN Number | 45-5112190 |
| Address: | 5422 1ST COAST HWY, Ste 108, Amelia Island, FL 32034 |
| Mail Address: | 2412 Los Robles dr, Amelia Island, FL 32034 |
| ZIP code: | 32034 |
| County: | Nassau |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1306192513 | 2012-07-25 | 2015-01-21 | 5422 FIRST COAST HWY, STE 119, AMELIA ISLAND, FL, 320345423, US | 5422 FIRST COAST HWY, STE 119, AMELIA ISLAND, FL, 320345423, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 904-432-7617 |
| Fax | 9044327088 |
Authorized person
| Name | DR. KENNETH F. JOHNSON |
| Role | ADMINISTRATOR OF BUSINESS |
| Phone | 3862353831 |
Taxonomy
| Taxonomy Code | 101Y00000X - Counselor |
| License Number | 5460 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 101YA0400X - Addiction (Substance Use Disorder) Counselor |
| License Number | 5460 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| License Number | 5548 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 101YP1600X - Pastoral Counselor |
| License Number | 5460 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 103T00000X - Psychologist |
| License Number | 5548 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 103TE1100X - Exercise & Sports Psychologist |
| License Number | 5548 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| License Number | MH5548 |
| State | FL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| JOHNSON, KEN F, Dr. | Agent | 2412 Los Robles dr, Amelia Island, FL 32034 |
| Name | Role | Address |
|---|---|---|
| JOHNSON, KEN F, Dr. | Managing Member | 2412 Los Robles dr, Amelia Island, FL 32034 |
| Name | Role | Address |
|---|---|---|
| Johnson, Michele E, CEO MGR | CEO MGR | 2412 Los Robles dr, Amelia Island, FL 32034 |
| Name | Role | Address |
|---|---|---|
| Johnson, Margaret E, Phd | Authorized Representative | 5422 1ST COAST HWY, Ste 108 Amelia Island, FL 32034 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-01-28 | 5422 1ST COAST HWY, Ste 108, Amelia Island, FL 32034 | No data |
| CHANGE OF MAILING ADDRESS | 2024-01-28 | 5422 1ST COAST HWY, Ste 108, Amelia Island, FL 32034 | No data |
| REGISTERED AGENT NAME CHANGED | 2024-01-28 | JOHNSON, KEN F, Dr. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-01-28 | 2412 Los Robles dr, Amelia Island, FL 32034 | No data |
| LC AMENDMENT | 2012-12-03 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-03 |
| ANNUAL REPORT | 2024-01-28 |
| ANNUAL REPORT | 2023-02-10 |
| ANNUAL REPORT | 2022-03-02 |
| ANNUAL REPORT | 2021-02-10 |
| ANNUAL REPORT | 2020-03-22 |
| ANNUAL REPORT | 2019-02-15 |
| ANNUAL REPORT | 2018-03-02 |
| ANNUAL REPORT | 2017-02-18 |
| AMENDED ANNUAL REPORT | 2016-09-26 |
Date of last update: 22 Feb 2025
Sources: Florida Department of State
