| Entity Name: | DR TRACY HUTCHINSON, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 15 Dec 2015 (9 years ago) |
| Document Number: | L15000207963 |
| FEI/EIN Number | 81-0705920 |
| Address: | 2740 Oak Ridge Circle Ste 301, Fort Myers, FL 33901 |
| Mail Address: | PO Box 1272, FORT MYERS, FL 33902 |
| ZIP code: | 33901 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1922473339 | 2015-12-10 | 2015-12-10 | 1342 COLONIAL BV, BUILDING F, STE 41A, FORT MYERS, FL, 33907, US | 1342 COLONIAL BV, BUILDING F, STE 41A, FORT MYERS, FL, 33907, US | |||||||||||||||||||||||||||||||
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| Phone | +1 239-931-4444 |
Authorized person
| Name | DR. TRACY HUTCHINSON |
| Role | LICENSED MENTAL HEALTH COUNSELOR |
| Phone | 2399314444 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| License Number | 0004240 |
| State | NY |
| Is Primary | No |
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| License Number | 13596 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | CAQH |
| Number | 12250153 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HUTCHINSON, TRACY | Agent | 2740 Oak Ridge Circle Ste 301, Fort Myers, FL 33901 |
| Name | Role | Address |
|---|---|---|
| Hutchinson, Dr. Tracy | PRESIDENT | 2740 Oak Ridge Circle Ste 301, Fort Myers, FL 33901 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-01-29 | 2740 Oak Ridge Circle Ste 301, Fort Myers, FL 33901 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-01-29 | 2740 Oak Ridge Circle Ste 301, Fort Myers, FL 33901 | No data |
| CHANGE OF MAILING ADDRESS | 2019-02-11 | 2740 Oak Ridge Circle Ste 301, Fort Myers, FL 33901 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-10 |
| ANNUAL REPORT | 2023-02-24 |
| ANNUAL REPORT | 2022-01-31 |
| ANNUAL REPORT | 2021-01-29 |
| ANNUAL REPORT | 2020-02-25 |
| ANNUAL REPORT | 2019-02-11 |
| ANNUAL REPORT | 2018-05-04 |
| ANNUAL REPORT | 2017-04-04 |
| Florida Limited Liability | 2015-12-15 |
Date of last update: 19 Feb 2025
Sources: Florida Department of State
