| Entity Name: | GREGORY VAN DAM, PSY.D. LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 06 Aug 2012 (12 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 28 Sep 2017 (7 years ago) |
| Document Number: | L12000101082 |
| FEI/EIN Number | 46-0731316 |
| Address: | 1936 Lee Rd., Winter Park, FL, 32789, US |
| Mail Address: | 1936 Lee Rd., Winter Park, FL, 32789, US |
| ZIP code: | 32789 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1689922528 | 2012-08-27 | 2017-04-12 | 1936 LEE RD, SUITE 290, WINTER PARK, FL, 327897229, US | 1936 LEE RD, SUITE 290, WINTER PARK, FL, 327897229, US | |||||||||||||||||||
|
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| Phone | +1 407-233-1864 |
| Fax | 4075633264 |
Authorized person
| Name | DR. GREGORY VAN DAM |
| Role | OWNER |
| Phone | 5612527336 |
Taxonomy
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| License Number | PY 8572 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| VAN DAM GREGORY | Agent | 1936 Lee Rd., Winter Park, FL, 32789 |
| Name | Role | Address |
|---|---|---|
| VAN DAM GREGORY | Managing Member | 1936 Lee Rd., Winter Park, FL, 32789 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G13000080886 | COMPREHENSIVE PSYCHOLOGY SERVICES | EXPIRED | 2013-08-14 | 2018-12-31 | No data | 8700 MAITLAND SUMMIT BLVD, #307, ORLANDO, FL, 32810 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2019-02-07 | 1936 Lee Rd., Suite 290, Winter Park, FL 32789 | No data |
| CHANGE OF MAILING ADDRESS | 2019-02-07 | 1936 Lee Rd., Suite 290, Winter Park, FL 32789 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-02-07 | 1936 Lee Rd., Suite 290, Winter Park, FL 32789 | No data |
| REINSTATEMENT | 2017-09-28 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2017-09-28 | VAN DAM, GREGORY | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-14 |
| ANNUAL REPORT | 2023-01-30 |
| ANNUAL REPORT | 2022-01-28 |
| ANNUAL REPORT | 2021-01-13 |
| ANNUAL REPORT | 2020-01-16 |
| ANNUAL REPORT | 2019-02-07 |
| ANNUAL REPORT | 2018-05-02 |
| REINSTATEMENT | 2017-09-28 |
| ANNUAL REPORT | 2016-03-09 |
| ANNUAL REPORT | 2015-01-07 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
