| Entity Name: | PHOENIX MENTAL HEALTH, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 25 Mar 2014 (11 years ago) |
| Document Number: | L14000049246 |
| FEI/EIN Number | 38-3927788 |
| Address: | 2440 SE FEDERAL HWY, STUART, FL 34994 |
| Mail Address: | 2440 SE FEDERAL HWY, STUART, FL 34994 |
| ZIP code: | 34994 |
| County: | Martin |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1780091884 | 2014-07-21 | 2014-07-21 | 2440 SE FEDERAL HWY, STUART, FL, 349944531, US | 2440 SE FEDERAL HWY, STUART, FL, 349944531, US | |||||||||||||||||
|
|||||||||||||||||||||
| Phone | +1 561-229-8314 |
Authorized person
| Name | LYNN E VARELA |
| Role | OWNER |
| Phone | 5612298314 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| License Number | MH12356 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| LEGACY TAX, INC. | Agent | 1818 S. AUSTRALIAN AVE., SUITE 202, WEST PALM BEACH, FL 33409 |
| Name | Role | Address |
|---|---|---|
| Latty, Alicia | Authorized Member | 2440 SE FEDERAL HWY, STUART, FL 34994 |
| NORTHSTAR COUNSELING, LLC | Authorized Member | No data |
| Name | Role | Address |
|---|---|---|
| Cardell, Jalyssa | Manager | 2440 SE FEDERAL HWY, STUART, FL 34994 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-13 |
| ANNUAL REPORT | 2023-03-14 |
| AMENDED ANNUAL REPORT | 2022-03-21 |
| ANNUAL REPORT | 2022-03-09 |
| ANNUAL REPORT | 2021-03-17 |
| ANNUAL REPORT | 2020-03-16 |
| ANNUAL REPORT | 2019-03-02 |
| ANNUAL REPORT | 2018-03-17 |
| ANNUAL REPORT | 2017-03-17 |
| ANNUAL REPORT | 2016-04-01 |
Date of last update: 22 Jan 2025
Sources: Florida Department of State
