| Entity Name: | THERAPEUTIC CONSULTING ASSOCIATES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 25 Aug 2014 (10 years ago) |
| Date of dissolution: | 19 Mar 2015 (10 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 19 Mar 2015 (10 years ago) |
| Document Number: | L14000132462 |
| Address: | 1912 HAMILTON STREET, SUITE #103, JACKSONVILLE, FL, 32210, US |
| Mail Address: | 1912 HAMILTON STREET, SUITE #103, JACKSONVILLE, FL, 32210, US |
| ZIP code: | 32210 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1558761841 | 2014-08-25 | 2014-08-25 | 1912 HAMILTON ST, SUITE #103, JACKSONVILLE, FL, 322102076, US | 1912 HAMILTON ST, SUITE #103, JACKSONVILLE, FL, 322102076, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 904-729-2719 |
| Fax | 9044858887 |
Authorized person
| Name | ANGELA LYNN HAINSWORTH |
| Role | RA |
| Phone | 9047292719 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| License Number | MH10676 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| License Number | MH10995 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 008141000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HAINSWORTH ANGELA | Agent | 1912 HAMILTON STREET, JACKSONVILLE, FL, 32210 |
| Name | Role | Address |
|---|---|---|
| BECKLES IRISH | Authorized Person | 1912 HAMILTON STREET SUITE #103, JACKSONVILLE, FL, 32210 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2015-03-19 | No data | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2015-03-19 |
| Florida Limited Liability | 2014-08-25 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
