| Entity Name: | ALLISON L NEVIN, PSY.D., PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 12 Jun 2013 (12 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 25 Jul 2013 (12 years ago) |
| Document Number: | L13000084957 |
| FEI/EIN Number | 46-3026127 |
| Address: | 3270 Suntree Blvd., Building B, MELBOURNE, FL, 32940, US |
| Mail Address: | 3950 Postridge Trl, Melbourne, FL, 32934-8439, US |
| ZIP code: | 32940 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1033558044 | 2013-06-24 | 2020-01-17 | 3682 N WICKHAM RD, SUITE B1 #270, MELBOURNE, FL, 329352325, US | 2306 S BABCOCK ST, MELBOURNE, FL, 329015308, US | |||||||||||||||||||||||||
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| Phone | +1 321-676-8990 |
| Fax | 3214994682 |
Authorized person
| Name | ALLISON L NEVIN |
| Role | PRESIDENT |
| Phone | 3216768990 |
Taxonomy
| Taxonomy Code | 103T00000X - Psychologist |
| License Number | PY7179 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 009822800 |
| State | FL |
| Name | Role |
|---|---|
| UNITED STATES CORPORATION AGENTS, INC. | Agent |
| Name | Role | Address |
|---|---|---|
| NEVIN ALLISON | Authorized Member | 2306 S. BABCOCK STREET, MELBOURNE, FL, 32901 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-03 | 3270 Suntree Blvd., Building B, Suite 1128, MELBOURNE, FL 32940 | No data |
| CHANGE OF MAILING ADDRESS | 2024-04-03 | 3270 Suntree Blvd., Building B, Suite 1128, MELBOURNE, FL 32940 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-02-02 | 476 RIVERSIDE AVE., JACKSONVILLE, FL 32202 | No data |
| LC AMENDMENT | 2013-07-25 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-03 |
| ANNUAL REPORT | 2023-04-18 |
| ANNUAL REPORT | 2022-01-23 |
| ANNUAL REPORT | 2021-01-30 |
| ANNUAL REPORT | 2020-01-14 |
| ANNUAL REPORT | 2019-04-11 |
| ANNUAL REPORT | 2018-04-05 |
| ANNUAL REPORT | 2017-04-02 |
| ANNUAL REPORT | 2016-04-13 |
| AMENDED ANNUAL REPORT | 2015-04-14 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
