| Entity Name: | SANDRA S CHAMPA LCSW CAP LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 20 Apr 2015 (10 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 10 Apr 2023 (2 years ago) |
| Document Number: | L15000068881 |
| FEI/EIN Number | 47-3779865 |
| Address: | 7437 PINE PARK DRIVE S, LAKE WORTH, FL, 33467, US |
| Mail Address: | 7437 PINE PARK DRIVE S, LAKE WORTH, FL, 33467, US |
| ZIP code: | 33467 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1750760526 | 2015-05-26 | 2015-05-26 | 5700 LAKE WORTH RD, SUITE 209-5, GREENACRES, FL, 334634727, US | 5700 LAKE WORTH RD, SUITE 209-5, GREENACRES, FL, 334634727, US | |||||||||||||||||||
|
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| Phone | +1 561-929-3792 |
| Fax | 5612651349 |
Authorized person
| Name | SANDRA S CHAMPA |
| Role | OWNER |
| Phone | 5619293792 |
Taxonomy
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| License Number | L15000068881 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CHAMPA SANDRA | Agent | 7437 PINE PARK DRIVE S, LAKE WORTH, FL, 33467 |
| Name | Role | Address |
|---|---|---|
| CHAMPA SANDRA | Manager | 7437 PINE PARK DRIVE S, LAKE WORTH, FL, 33467 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2023-04-10 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-04-10 | 7437 PINE PARK DRIVE S, LAKE WORTH, FL 33467 | No data |
| CHANGE OF MAILING ADDRESS | 2023-04-10 | 7437 PINE PARK DRIVE S, LAKE WORTH, FL 33467 | No data |
| REGISTERED AGENT NAME CHANGED | 2023-04-10 | CHAMPA, SANDRA | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-04-10 | 7437 PINE PARK DRIVE S, LAKE WORTH, FL 33467 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-29 |
| REINSTATEMENT | 2023-04-10 |
| ANNUAL REPORT | 2021-04-05 |
| ANNUAL REPORT | 2020-03-18 |
| ANNUAL REPORT | 2019-03-09 |
| ANNUAL REPORT | 2018-03-19 |
| ANNUAL REPORT | 2017-04-11 |
| ANNUAL REPORT | 2016-04-02 |
| Florida Limited Liability | 2015-04-20 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
