| Entity Name: | LAIRD KHEPERA INSTITUTE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 13 Mar 2014 (11 years ago) |
| Document Number: | L14000041887 |
| FEI/EIN Number | 46-3996597 |
| Address: | 2961 1ST AVENUE NORTH, ST. PETERSBURG, FL, 33713, US |
| Mail Address: | 2961 1ST AVENUE NORTH, ST. PETERSBURG, FL, 33713, US |
| ZIP code: | 33713 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1265846208 | 2014-06-18 | 2014-06-18 | 2365 5TH AVE N, ST PETERSBURG, FL, 337137005, US | 2365 5TH AVE N, ST PETERSBURG, FL, 337137005, US | |||||||||||||||||||||||||||||||||||||
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| Phone | +1 727-793-9376 |
| Fax | 8664793677 |
Authorized person
| Name | DR. NYAMEKYE LAIRD |
| Role | PSYCHOLOGIST |
| Phone | 7277939376 |
Taxonomy
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| License Number | PY7843 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | AETNA |
| Number | 9741408 |
| State | FL |
| Issuer | NPI |
| Number | 1962588392 |
| State | FL |
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | 5932Q |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LAIRD NYAMEKYE | Agent | 2961 1ST AVENUE NORTH, ST. PETERSBURG, FL, 33713 |
| Name | Role | Address |
|---|---|---|
| LAIRD NYAMEKYE | Owner | 2961 1ST AVE NORTH, ST. PETERSBURG, FL, 33713 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2015-03-05 | 2961 1ST AVENUE NORTH, ST. PETERSBURG, FL 33713 | No data |
| CHANGE OF MAILING ADDRESS | 2015-03-05 | 2961 1ST AVENUE NORTH, ST. PETERSBURG, FL 33713 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2015-03-05 | 2961 1ST AVENUE NORTH, ST. PETERSBURG, FL 33713 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-26 |
| ANNUAL REPORT | 2023-04-05 |
| ANNUAL REPORT | 2022-03-10 |
| ANNUAL REPORT | 2021-04-16 |
| ANNUAL REPORT | 2020-02-07 |
| ANNUAL REPORT | 2019-05-03 |
| ANNUAL REPORT | 2018-01-23 |
| ANNUAL REPORT | 2017-04-05 |
| ANNUAL REPORT | 2016-03-03 |
| ANNUAL REPORT | 2015-03-05 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
