| Entity Name: | SHINING LIGHT COUNSELING LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 25 Jun 2015 (10 years ago) |
| Document Number: | L15000110838 |
| FEI/EIN Number | 47-4432019 |
| Address: | 820 S Duncan Dr, Tavares, FL, 32778, US |
| Mail Address: | 820 S Duncan Dr, Tavares, FL, 32778, US |
| ZIP code: | 32778 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1629433297 | 2015-12-23 | 2021-12-27 | 820 S DUNCAN DR, TAVARES, FL, 327784044, US | 820 S DUNCAN DR, TAVARES, FL, 327784044, US | |||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 352-357-1955 |
Authorized person
| Name | MR. BRUCE BARBRE |
| Role | OFFICE MANAGER |
| Phone | 4072564260 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| License Number | MH13825 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | Yes |
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| Is Primary | No |
| Taxonomy Code | 106H00000X - Marriage & Family Therapist |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 016389301 |
| State | FL |
| Issuer | MEDICAID |
| Number | 016389300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LEFLER BRANDI | Agent | 820 S Duncan Dr, Tavares, FL, 32778 |
| Name | Role | Address |
|---|---|---|
| LEFLER BRANDI | Manager | 820 S Duncan Dr, Tavares, FL, 32778 |
| Barbre Bruce | Manager | 820 S Duncan Dr, Tavares, FL, 32778 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G15000073730 | LIFE AND HOPE COUNSELING CENTER | ACTIVE | 2015-07-15 | 2025-12-31 | No data | 4400 N HIGHWAY 19A, SUITE 5, MOUNT DORA, FL, 32757 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-03-18 | 820 S Duncan Dr, Tavares, FL 32778 | No data |
| CHANGE OF MAILING ADDRESS | 2022-03-18 | 820 S Duncan Dr, Tavares, FL 32778 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-03-18 | 820 S Duncan Dr, Tavares, FL 32778 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-14 |
| ANNUAL REPORT | 2023-03-07 |
| ANNUAL REPORT | 2022-03-18 |
| ANNUAL REPORT | 2021-04-19 |
| ANNUAL REPORT | 2020-03-11 |
| ANNUAL REPORT | 2019-03-20 |
| ANNUAL REPORT | 2018-02-13 |
| ANNUAL REPORT | 2017-03-15 |
| ANNUAL REPORT | 2016-06-07 |
| Florida Limited Liability | 2015-06-25 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
