| Entity Name: | GRACEFUL WAY COUNSELING, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 10 Aug 2015 (10 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 07 Nov 2024 (3 months ago) |
| Document Number: | L15000136531 |
| FEI/EIN Number | 47-4785341 |
| Address: | 7885 venture center way, apt 8201, Boynton beach, FL, 33437, US |
| Mail Address: | 7885 venture center way, apt 8201, Boynton beach, FL, 33437, US |
| ZIP code: | 33437 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1972953941 | 2016-06-20 | 2019-04-27 | 1035 S STATE ROAD 7 STE 315, WELLINGTON, FL, 334146137, US | 1035 S STATE ROAD 7 STE 315, WELLINGTON, FL, 33414, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 561-571-5501 |
| Fax | 5617918039 |
Authorized person
| Name | CELESTINE MARIE QUIROGA |
| Role | CEO |
| Phone | 5615715501 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| License Number | MH12300 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | No |
| Taxonomy Code | 261QM0855X - Adolescent and Children Mental Health Clinic/Center |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 014645000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| QUIROGA CELESTINE | Agent | 7885 venture center way, Boynton beach, FL, 33437 |
| Name | Role | Address |
|---|---|---|
| QUIROGA CELESTINE | Manager | 7885 venture center way, Boynton beach, FL, 33437 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-11-07 | 7885 venture center way, apt 8201, Boynton beach, FL 33437 | No data |
| CHANGE OF MAILING ADDRESS | 2024-11-07 | 7885 venture center way, apt 8201, Boynton beach, FL 33437 | No data |
| REGISTERED AGENT NAME CHANGED | 2024-11-07 | QUIROGA, CELESTINE | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-11-07 | 7885 venture center way, apt 8201, Boynton beach, FL 33437 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2024-09-27 | No data | No data |
| Name | Date |
|---|---|
| REINSTATEMENT | 2024-11-07 |
| ANNUAL REPORT | 2023-04-30 |
| ANNUAL REPORT | 2022-04-14 |
| ANNUAL REPORT | 2021-04-13 |
| ANNUAL REPORT | 2020-06-12 |
| ANNUAL REPORT | 2019-04-26 |
| ANNUAL REPORT | 2018-04-25 |
| ANNUAL REPORT | 2017-04-27 |
| ANNUAL REPORT | 2016-04-30 |
| Florida Limited Liability | 2015-08-10 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
