| Entity Name: | MIND BODY PSYCHOLOGY SERVICES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 14 Aug 2015 (9 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 04 Sep 2015 (9 years ago) |
| Document Number: | L15000139533 |
| FEI/EIN Number | 474860335 |
| Address: | 4600 Military Trail, Jupiter, FL, 33458, US |
| Mail Address: | 4600 Military Trail, Jupiter, FL, 33458, US |
| ZIP code: | 33458 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1396112157 | 2015-08-27 | 2023-08-03 | 4600 MILITARY TRL STE 103, JUPITER, FL, 334584811, US | 4600 MILITARY TRL STE 103, JUPITER, FL, 334584811, US | |||||||||||||||||
|
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| Phone | +1 561-249-7400 |
Authorized person
| Name | DR. LISA SMALHEISER |
| Role | CLINICAL PSYCHOLOGIST |
| Phone | 9548292975 |
Taxonomy
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| License Number | PY 9109 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| SMALHEISER LISA | Agent | 4600 Military Trail, Jupiter, FL, 33458 |
| Name | Role | Address |
|---|---|---|
| SMALHEISER LISA | Manager | 4600 Military Trail, Jupiter, FL, 33458 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-09-14 | 4600 Military Trail, Suite 103, Jupiter, FL 33458 | No data |
| CHANGE OF MAILING ADDRESS | 2021-09-14 | 4600 Military Trail, Suite 103, Jupiter, FL 33458 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-09-14 | 4600 Military Trail, Suite 103, Jupiter, FL 33458 | No data |
| LC AMENDMENT | 2015-09-04 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-10 |
| ANNUAL REPORT | 2023-01-20 |
| ANNUAL REPORT | 2022-01-19 |
| AMENDED ANNUAL REPORT | 2021-09-14 |
| ANNUAL REPORT | 2021-02-10 |
| ANNUAL REPORT | 2020-04-06 |
| ANNUAL REPORT | 2019-03-12 |
| ANNUAL REPORT | 2018-01-03 |
| ANNUAL REPORT | 2017-01-11 |
| ANNUAL REPORT | 2016-09-03 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
