| Entity Name: | BRIAN GONG PSYCHOTHERAPY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 15 May 2017 (8 years ago) |
| Document Number: | L17000107101 |
| FEI/EIN Number | 82-1586547 |
| Address: | 401 Linton Blvd Ste 200-A, DELRAY BEACH, FL 33444 |
| Mail Address: | 401 Linton Blvd Ste 200-A, Mailbox 5, DELRAY BEACH, FL 33444 |
| ZIP code: | 33444 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1033614037 | 2018-03-29 | 2020-09-18 | 401 LINTON BLVD, SUITE 200-A, DELRAY BEACH, FL, 33444, US | 401 LINTON BLVD, SUITE 200-A, DELRAY BEACH, FL, 33444, US | |||||||||||||||
|
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| Phone | +1 561-501-1008 |
| Fax | 5614312608 |
Authorized person
| Name | MR. BRIAN MICHAEL GONG |
| Role | OWNER/PHYCOTHERAPIST |
| Phone | 5615011008 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | Yes |
| Name | Role |
|---|---|
| REGISTERED AGENTS INC | Agent |
| Name | Role | Address |
|---|---|---|
| Gong, Brian M | Chief Executive Officer | 401 Linton Blvd, 200-A DELRAY BEACH, FL 33444 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-03-02 | 401 Linton Blvd Ste 200-A, DELRAY BEACH, FL 33444 | No data |
| CHANGE OF MAILING ADDRESS | 2023-03-02 | 401 Linton Blvd Ste 200-A, DELRAY BEACH, FL 33444 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-06-09 | 7901 4th St N, STE 300, ST.PETERSBURG, FL 33702 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-04 |
| ANNUAL REPORT | 2023-03-02 |
| ANNUAL REPORT | 2022-03-04 |
| ANNUAL REPORT | 2021-04-07 |
| ANNUAL REPORT | 2020-06-09 |
| ANNUAL REPORT | 2019-02-08 |
| ANNUAL REPORT | 2018-02-11 |
| Florida Limited Liability | 2017-05-15 |
Date of last update: 18 Feb 2025
Sources: Florida Department of State
