| Entity Name: | CENTER FOR PSYCHOLOGICAL AND FORENSIC SERVICES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 09 Sep 2014 (10 years ago) |
| Document Number: | L14000140494 |
| FEI/EIN Number | 47-1851029 |
| Address: | 6801 LAKE WORTH ROAD, SUITE 122, GREENACRES, FL, 33467, US |
| Mail Address: | 6801 LAKE WORTH ROAD, SUITE 122, GREENACRES, FL, 33467, US |
| ZIP code: | 33467 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1659763191 | 2015-02-20 | 2015-02-20 | 6801 LAKE WORTH RD, SUITE 122, GREENACRES, FL, 334672955, US | 6801 LAKE WORTH RD, SUITE 122, GREENACRES, FL, 334672955, US | |||||||||||||||||
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| Phone | +1 561-318-5340 |
Authorized person
| Name | DR. KATHY ROSALIE NICHOLLS |
| Role | PRESIDENT/CLINICAL DIRECTOR |
| Phone | 5613704469 |
Taxonomy
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| License Number | PY8492 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| NICHOLLS KATHYANN R | Agent | 6801 LAKE WORTH ROAD, SUITE 122, GREENACRES, FL, 33467 |
| Name | Role | Address |
|---|---|---|
| NICHOLLS KATHYANN R | Owne | 6801 LAKE WORTH ROAD, SUITE 122, GREENACRES, FL, 33467 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2015-04-30 | 6801 LAKE WORTH ROAD, SUITE 122, GREENACRES, FL 33467 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2014-12-19 | 6801 LAKE WORTH ROAD, SUITE 122, GREENACRES, FL 33467 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-08 |
| ANNUAL REPORT | 2023-04-11 |
| ANNUAL REPORT | 2022-03-01 |
| ANNUAL REPORT | 2021-03-05 |
| ANNUAL REPORT | 2020-03-05 |
| ANNUAL REPORT | 2019-04-04 |
| ANNUAL REPORT | 2018-04-14 |
| ANNUAL REPORT | 2017-04-11 |
| ANNUAL REPORT | 2016-04-20 |
| ANNUAL REPORT | 2015-04-30 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
