| Entity Name: | MARY DEAN ATWOOD PHD., LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 04 May 2012 (13 years ago) |
| Date of dissolution: | 28 Sep 2018 (6 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2018 (6 years ago) |
| Document Number: | L12000060614 |
| FEI/EIN Number | 71-1001905 |
| Address: | 3947 35TH WAY S. #131, St. Petersburg, FL, 33711, US |
| Mail Address: | 3947 35TH WAY S. #131, St. Petersburg, FL, 33711, US |
| ZIP code: | 33711 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1760435754 | 2006-05-18 | 2012-05-03 | 4070 OAKHURST DR, SARASOTA, FL, 342331444, US | 4070 OAKHURST DR, SARASOTA, FL, 342331444, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 941-487-7890 |
| Fax | 9414877890 |
Authorized person
| Name | MARY DEAN ATWOOD |
| Role | PRESIDENT/PSYCHOLOGIST |
| Phone | 9414877890 |
Taxonomy
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| License Number | 550 |
| State | NM |
| Is Primary | Yes |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| License Number | 550 |
| State | NM |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 62786768 |
| State | NM |
| Name | Role | Address |
|---|---|---|
| ATWOOD MARY dPhd | Agent | 3947 35TH WAY S. #131, St. Petersburg, FL, 33711 |
| Name | Role | Address |
|---|---|---|
| Atwood Mary DPhd | Manager | 3947 35TH WAY S. #131, St. Petersburg, FL, 33711 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| LC REVOCATION OF DISSOLUTION | 2017-03-14 | No data | No data |
| VOLUNTARY DISSOLUTION | 2017-01-17 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2016-10-31 | ATWOOD, MARY dean, Phd | No data |
| REINSTATEMENT | 2016-10-31 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2015-02-23 | 3947 35TH WAY S. #131, St. Petersburg, FL 33711 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2015-02-23 | 3947 35TH WAY S. #131, St. Petersburg, FL 33711 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2015-02-23 | 3947 35TH WAY S. #131, St. Petersburg, FL 33711 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2017-04-05 |
| LC Revocation of Dissolution | 2017-03-14 |
| VOLUNTARY DISSOLUTION | 2017-01-17 |
| REINSTATEMENT | 2016-10-31 |
| ANNUAL REPORT | 2015-02-23 |
| ANNUAL REPORT | 2014-03-19 |
| ANNUAL REPORT | 2013-03-13 |
| Florida Limited Liability | 2012-05-04 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
