| Entity Name: | ERIC HEDEAN LAMB LCSW, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 14 Mar 2017 (8 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 01 Nov 2023 (a year ago) |
| Document Number: | L17000058690 |
| FEI/EIN Number | 82-0790969 |
| Address: | 495 GRAND BOULEVARD, MIRAMAR BEACH, FL, 32550, US |
| Mail Address: | 495 GRAND BOULEVARD, MIRAMAR BEACH, FL, 32550, US |
| ZIP code: | 32550 |
| County: | Walton |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1437673969 | 2017-07-26 | 2024-03-27 | 495 GRAND BLVD STE 206, MIRAMAR BEACH, FL, 325501897, US | 495 GRAND BLVD STE 206, MIRAMAR BEACH, FL, 325501897, US | |||||||||||||||||||||||||
|
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| Phone | +1 847-404-4855 |
| Fax | 8506136184 |
Authorized person
| Name | ERIC H LAMB |
| Role | PRESIDENT |
| Phone | 8474044855 |
Taxonomy
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| License Number | SW12114 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 022552800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LAMB ERIC H | Agent | 513 Taylor Circle, Ft. Walton Beach, FL, 32547 |
| Name | Role | Address |
|---|---|---|
| LAMB ERIC H | Manager | 38 11th St, Shalimar, FL, 32579 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-19 | 495 GRAND BOULEVARD, SUITE 206, MIRAMAR BEACH, FL 32550 | No data |
| CHANGE OF MAILING ADDRESS | 2024-04-19 | 495 GRAND BOULEVARD, SUITE 206, MIRAMAR BEACH, FL 32550 | No data |
| REINSTATEMENT | 2023-11-01 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-12-19 | 513 Taylor Circle, Ft. Walton Beach, FL 32547 | No data |
| REINSTATEMENT | 2022-12-19 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2022-12-19 | LAMB, ERIC H | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-19 |
| REINSTATEMENT | 2023-11-01 |
| REINSTATEMENT | 2022-12-19 |
| ANNUAL REPORT | 2021-05-04 |
| ANNUAL REPORT | 2020-06-29 |
| ANNUAL REPORT | 2019-04-30 |
| ANNUAL REPORT | 2018-01-22 |
| Florida Limited Liability | 2017-03-14 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
