| Entity Name: | SUDS COUNSELING LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 10 Oct 2017 (7 years ago) |
| Document Number: | L17000209632 |
| FEI/EIN Number | 82-3028278 |
| Address: | 4519 WOODBINE RD, PACE, FL, 32571, US |
| Mail Address: | 4519 WOODBINE RD, PACE, FL, 32571, US |
| ZIP code: | 32571 |
| County: | Santa Rosa |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1669171955 | 2023-02-27 | 2023-02-27 | 4519 WOODBINE RD, MILTON, FL, 325718706, US | 4519 WOODBINE RD, MILTON, FL, 325718706, US | |||||||||||||||||||||
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| Phone | +1 850-778-3747 |
| Fax | 8508075147 |
Authorized person
| Name | JENNIFER VAUGHN |
| Role | THERAPIST/ OWNER |
| Phone | 8507783747 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 110551400 |
| State | FL |
| Name | Role |
|---|---|
| DURST JORDAN, CPA, PA | Agent |
| Name | Role | Address |
|---|---|---|
| STEWART VAUGHN JENNIFER A | Managing Member | 4519 WOODBINE RD, PACE, FL, 32571 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000034007 | RESILIENCY WELL | ACTIVE | 2023-03-14 | 2028-12-31 | No data | 4519 WOODBINE RD, PACE, FL, 32571 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-04-27 | 4519 WOODBINE RD, PACE, FL 32571 | No data |
| CHANGE OF MAILING ADDRESS | 2023-04-27 | 4519 WOODBINE RD, PACE, FL 32571 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-23 |
| ANNUAL REPORT | 2023-04-27 |
| ANNUAL REPORT | 2022-04-27 |
| ANNUAL REPORT | 2021-04-26 |
| ANNUAL REPORT | 2020-06-29 |
| ANNUAL REPORT | 2019-04-17 |
| ANNUAL REPORT | 2018-05-01 |
| Florida Limited Liability | 2017-10-10 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
