| Entity Name: | LYON COUNSELING LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 05 Jul 2017 (8 years ago) |
| Document Number: | L17000144356 |
| FEI/EIN Number | 82-2077289 |
| Address: | 315 N WYMORE ROAD, WINTER PARK, FL 32789 |
| Mail Address: | 315 N WYMORE ROAD, WINTER PARK, FL 32789 |
| ZIP code: | 32789 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1073092722 | 2018-08-13 | 2020-03-18 | 661 SEMINOLA BLVD, CASSELBERRY, FL, 327073057, US | 661 SEMINOLA BLVD, CASSELBERRY, FL, 327073057, US | |||||||||||||||||||||||
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| Phone | +1 321-430-5966 |
Authorized person
| Name | JESSE LYON |
| Role | OWNER |
| Phone | 3214305966 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | Yes |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1015506-00 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LYON, JESSE | Agent | 315 N Wymore Rd., Winter Park, FL 32789 |
| Name | Role | Address |
|---|---|---|
| LYON, JESSE | Manager | 1501 West Colonial Drive, Orlando, FL 32804 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-09-27 | 315 N WYMORE ROAD, WINTER PARK, FL 32789 | No data |
| CHANGE OF MAILING ADDRESS | 2021-09-27 | 315 N WYMORE ROAD, WINTER PARK, FL 32789 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-02-15 | 315 N Wymore Rd., Winter Park, FL 32789 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-12 |
| ANNUAL REPORT | 2023-03-15 |
| ANNUAL REPORT | 2022-04-27 |
| ANNUAL REPORT | 2021-02-15 |
| ANNUAL REPORT | 2020-03-02 |
| ANNUAL REPORT | 2019-01-07 |
| ANNUAL REPORT | 2018-04-24 |
| Florida Limited Liability | 2017-07-05 |
Date of last update: 18 Jan 2025
Sources: Florida Department of State
