| Entity Name: | MICHAEL BETTENCOURT LCSW, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
MICHAEL BETTENCOURT LCSW, LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 17 Jan 2017 (8 years ago) |
| Date of dissolution: | 27 Sep 2019 (6 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2019 (6 years ago) |
| Document Number: | L17000011280 |
| FEI/EIN Number |
81-5222411
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 2805 OAKLAND PARK BLVD #174, FORT LAUDERDALE, FL, 33306, US |
| Mail Address: | 2805 OAKLAND PARK BLVD #174, FORT LAUDERDALE, FL, 33306, US |
| ZIP code: | 33306 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1891998720 | 2007-06-07 | 2018-03-19 | 2805 E OAKLAND PARK BLVD # 174, FORT LAUDERDALE, FL, 333061813, US | 2805 E OAKLAND PARK BLVD # 174, FORT LAUDERDALE, FL, 333061813, US | |||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 617-869-6182 |
Authorized person
| Name | MR. MICHAEL BETTENCOURT |
| Role | PRESIDENT |
| Phone | 6178696182 |
Taxonomy
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| License Number | 111335 |
| State | MA |
| Is Primary | No |
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| License Number | 13063 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1852612 |
| State | MA |
| Issuer | TUFTS PROVIDER NUMBER |
| Number | 461417 |
| State | MA |
| Issuer | BCBS PROVIDER NUMBER |
| Number | P08075 |
| State | MA |
| Name | Role | Address |
|---|---|---|
| BETTENCOURT MICHAEL LCSW | Manager | 2805 OAKLAND PARK BLVD #174, FORT LAUDERDALE, FL, 33306 |
| BETTENCOURT MICHAEL LCSW | President | 2805 OAKLAND PARK BLVD #174, FORT LAUDERDALE, FL, 33306 |
| BETTENCOURT MICHAEL LCSW | Agent | 2805 OAKLAND PARK BLVD #174, FORT LAUDERDALE, FL, 33306 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | - | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2018-04-27 |
| Florida Limited Liability | 2017-01-17 |
Date of last update: 01 Apr 2025
Sources: Florida Department of State
