| Entity Name: | PENSACOLA COUNSELOR LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 17 Sep 2015 (9 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 21 Oct 2016 (8 years ago) |
| Document Number: | L15000158444 |
| FEI/EIN Number | 475100222 |
| Address: | 4300 BAYOU BLVD, SUITE 21, PENSACOLA, FL, 32503, US |
| Mail Address: | 4300 BAYOU BLVD, SUITE 21, PENSACOLA, FL, 32503, US |
| ZIP code: | 32503 |
| County: | Escambia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1407220494 | 2015-11-14 | 2015-11-14 | 4300 BAYOU BLVD, SUITE 21, PENSACOLA, FL, 325031949, US | 4300 BAYOU BLVD, SUITE 21, PENSACOLA, FL, 325031949, US | |||||||||||||||||||||||||||||||
|
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| Phone | +1 850-462-3595 |
| Fax | 8506072771 |
Authorized person
| Name | REGAN HAGER |
| Role | OWNER/PRESIDENT |
| Phone | 8504623595 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| License Number | MH12078 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 009764400 |
| State | FL |
| Issuer | MEDICAID |
| Number | 009812400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HAGER REGAN E | Agent | 4300 BAYOU BLVD, PENSACOLA, FL, 32503 |
| Name | Role | Address |
|---|---|---|
| HAGER REGAN E | Manager | 4300 BAYOU BLVD STE 21, PENSACOLA, FL, 32503 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2016-10-21 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2016-10-21 | HAGER, REGAN E | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-29 |
| ANNUAL REPORT | 2023-01-26 |
| ANNUAL REPORT | 2022-02-08 |
| ANNUAL REPORT | 2021-01-31 |
| ANNUAL REPORT | 2020-02-28 |
| ANNUAL REPORT | 2019-02-15 |
| ANNUAL REPORT | 2018-03-06 |
| ANNUAL REPORT | 2017-03-03 |
| REINSTATEMENT | 2016-10-21 |
| Florida Limited Liability | 2015-09-17 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
