| Entity Name: | SHANA J. WILLIAMS, PSY.D, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 08 May 2015 (10 years ago) |
| Document Number: | L15000081985 |
| FEI/EIN Number | 90-1112776 |
| Address: | 4741 SW 57TH AVENUE, DAVIE, FL, 33314, US |
| Mail Address: | 4741 SW 57TH AVENUE, DAVIE, FL, 33314, US |
| ZIP code: | 33314 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1295186120 | 2016-06-22 | 2016-06-22 | 440 SAWGRASS CORPORATE PKWY, SUNRISE, FL, 333256244, US | 440 SAWGRASS CORPORATE PKWY, SUNRISE, FL, 333256244, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 954-298-8774 |
| Fax | 9547451120 |
Authorized person
| Name | DR. SHANA WILLIAMS |
| Role | CLINICAL PSYCHOLOGIST |
| Phone | 9542988774 |
Taxonomy
| Taxonomy Code | 103T00000X - Psychologist |
| License Number | PY5937 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 103TA0700X - Adult Development & Aging Psychologist |
| License Number | PY5937 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 103TB0200X - Cognitive & Behavioral Psychologist |
| License Number | PY5937 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| License Number | PY5937 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 103TC1900X - Counseling Psychologist |
| License Number | PY5937 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 103TC2200X - Clinical Child & Adolescent Psychologist |
| License Number | PY5937 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 103TF0200X - Forensic Psychologist |
| License Number | PY5937 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 103TM1800X - Intellectual & Developmental Disabilities Psychologist |
| License Number | PY5937 |
| State | FL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| KEESING & ASSOCIATES, INC | Agent | 9153 SW 206TH STREET, MIAMI, FL, 33189 |
| Name | Role | Address |
|---|---|---|
| WILLIAMS SHANA J | Manager | 4741 SW 57TH AVENUE, DAVIE, FL, 33314 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-29 |
| ANNUAL REPORT | 2023-03-29 |
| ANNUAL REPORT | 2022-04-07 |
| ANNUAL REPORT | 2021-04-15 |
| ANNUAL REPORT | 2020-04-18 |
| ANNUAL REPORT | 2019-04-08 |
| ANNUAL REPORT | 2018-04-10 |
| ANNUAL REPORT | 2017-02-12 |
| ANNUAL REPORT | 2016-04-28 |
| Florida Limited Liability | 2015-05-08 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
