| Entity Name: | LIFESPAN PSYCHOLOGY SERVICES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 18 May 2012 (13 years ago) |
| Document Number: | L12000067374 |
| FEI/EIN Number | 45-5325823 |
| Address: | 4882 Majestic Hills Loop, #1603, Brooksville, FL, 34601, US |
| Mail Address: | 4882 MAJESTIC HILLS LOOP, BROOKSVILLE, FL, 34601, US |
| ZIP code: | 34601 |
| County: | Hernando |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1770844433 | 2012-05-30 | 2012-05-30 | 4201 BAYSHORE BLVD, UNIT 1603, TAMPA, FL, 336111669, US | 4201 BAYSHORE BLVD, UNIT 1603, TAMPA, FL, 336111669, US | |||||||||||||
|
|||||||||||||||||
| Phone | +1 617-784-0771 |
Authorized person
| Name | DR. ATHENA BOOLUKOS GORDON |
| Role | PRESIDENT |
| Phone | 6177840771 |
Taxonomy
| Taxonomy Code | 103T00000X - Psychologist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| GORDON ATHENA | Agent | 4882 MAJESTIC HILLS LOOP, BROOKSVILLE, FL, 34601 |
| Name | Role | Address |
|---|---|---|
| GORDON ATHENA B | Manager | 4882 MAJESTIC HILLS LOOP, BROOKSVILLE, FL, 34601 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2024-02-24 | 4882 Majestic Hills Loop, #1603, Brooksville, FL 34601 | No data |
| REGISTERED AGENT NAME CHANGED | 2024-02-24 | GORDON, ATHENA | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-02-24 | 4882 MAJESTIC HILLS LOOP, BROOKSVILLE, FL 34601 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-05-09 | 4882 Majestic Hills Loop, #1603, Brooksville, FL 34601 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-24 |
| ANNUAL REPORT | 2023-02-05 |
| ANNUAL REPORT | 2022-01-24 |
| ANNUAL REPORT | 2021-02-01 |
| ANNUAL REPORT | 2020-02-02 |
| ANNUAL REPORT | 2019-02-14 |
| ANNUAL REPORT | 2018-03-04 |
| ANNUAL REPORT | 2017-02-11 |
| ANNUAL REPORT | 2016-02-20 |
| ANNUAL REPORT | 2015-02-11 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
