| Entity Name: | COTLER CHILDREN & FAMILY SERVICES LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 15 Dec 2015 (9 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 21 Apr 2017 (8 years ago) |
| Document Number: | L15000207929 |
| FEI/EIN Number | 81-1033282 |
| Address: | 8461 Lake Worth Road, Suite 250, Lake Worth, FL, 33467, US |
| Mail Address: | 9835 Lake Worth Road, Suite 16-179, Lake Worth, FL, 33467, US |
| ZIP code: | 33467 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1861858581 | 2016-01-11 | 2017-09-25 | 11120 S CROWN WAY, SUITE 1, WELLINGTON, FL, 334148718, US | 11120 S CROWN WAY, SUITE 1, WELLINGTON, FL, 334148718, US | |||||||||||||||||||||||||||||||||
|
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| Phone | +1 561-790-1191 |
Authorized person
| Name | KERRY M COTLER |
| Role | CLINICAL PSYCHOLOGIST |
| Phone | 5617901191 |
Taxonomy
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| Is Primary | No |
| Taxonomy Code | 251B00000X - Case Management Agency |
| Is Primary | No |
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 016640000 |
| State | FL |
| Issuer | MEDICAID |
| Number | 017326800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Cotler Kerry MPhd | Agent | 9835 Lake Worth Road, Lake Worth, FL, 33467 |
| Name | Role | Address |
|---|---|---|
| COTLER KERRY M | President | 11120 S Crown Way, Wellington, FL, 33414 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G17000115395 | COTLER CLINICAL SERVICES | ACTIVE | 2017-10-19 | 2027-12-31 | No data | 11120 S CROWN WAY, SUITE 1, WELLINGTON, FL, 33414 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-02-19 | 8461 Lake Worth Road, Suite 250, Lake Worth, FL 33467 | No data |
| CHANGE OF MAILING ADDRESS | 2024-02-19 | 8461 Lake Worth Road, Suite 250, Lake Worth, FL 33467 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-02-19 | 9835 Lake Worth Road, Suite 16-179, Lake Worth, FL 33467 | No data |
| REINSTATEMENT | 2017-04-21 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2017-04-21 | Cotler, Kerry M, Phd | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-19 |
| ANNUAL REPORT | 2023-01-31 |
| ANNUAL REPORT | 2022-02-04 |
| ANNUAL REPORT | 2021-01-29 |
| ANNUAL REPORT | 2020-03-23 |
| ANNUAL REPORT | 2019-02-22 |
| ANNUAL REPORT | 2018-01-19 |
| REINSTATEMENT | 2017-04-21 |
| Florida Limited Liability | 2015-12-15 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
