| Entity Name: | HANCOCK-SMITH PEDIATRIC & BEHAVIORAL HEALTH, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 07 Aug 2017 (8 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 08 Oct 2018 (6 years ago) |
| Document Number: | L17000167570 |
| FEI/EIN Number | 83-1042284 |
| Address: | 13900 Tech City Circle, ALACHUA, FL, 32615, US |
| Mail Address: | PO BOX 305, ALACHUA, FL, 32616-0305, US |
| ZIP code: | 32615 |
| County: | Alachua |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1396354858 | 2020-07-29 | 2021-08-02 | PO BOX 305, ALACHUA, FL, 326160305, US | 13900 TECH CITY CIR STE 408, ALACHUA, FL, 326156090, US | |||||||||||||||||||||||||
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| Phone | +1 386-518-6006 |
| Fax | 3855186024 |
| Fax | 3865186024 |
Authorized person
| Name | DR. ANYALIESE DOMINIQUE HANCOCK-SMITH |
| Role | OWNER & LICENSED PSYCHOLOGIST |
| Phone | 3865186006 |
Taxonomy
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | No |
| Taxonomy Code | 261QM0850X - Adult Mental Health Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QM0855X - Adolescent and Children Mental Health Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| HANCOCK-SMITH ANYALIESE DPH.D. | Agent | 14838 NW 149TH PLACE, ALACHUA, FL, 32615 |
| Name | Role | Address |
|---|---|---|
| HANCOCK-SMITH ANYALIESE DDR. | Manager | 14838 NW 149TH PLACE, ALACHUA, FL, 32615 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-03-07 | 13900 Tech City Circle, SUITE 408, ALACHUA, FL 32615 | No data |
| CHANGE OF MAILING ADDRESS | 2019-04-29 | 13900 Tech City Circle, SUITE 408, ALACHUA, FL 32615 | No data |
| REINSTATEMENT | 2018-10-08 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2018-10-08 | HANCOCK-SMITH, ANYALIESE D, PH.D. | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| LC AMENDMENT AND NAME CHANGE | 2018-06-11 | HANCOCK-SMITH PEDIATRIC & BEHAVIORAL HEALTH, LLC | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-29 |
| ANNUAL REPORT | 2023-01-26 |
| ANNUAL REPORT | 2022-01-21 |
| ANNUAL REPORT | 2021-03-07 |
| ANNUAL REPORT | 2020-05-25 |
| ANNUAL REPORT | 2019-04-29 |
| REINSTATEMENT | 2018-10-08 |
| LC Amendment and Name Change | 2018-06-11 |
| Florida Limited Liability | 2017-08-07 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
