| Entity Name: | CHILDREN'S PSYCHOLOGICAL SERVICES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 02 Jan 2018 (7 years ago) |
| Document Number: | L18000000134 |
| FEI/EIN Number | 82-3875334 |
| Address: | 9040 Town Center Parkway, Lakewood Ranch, FL 34202 |
| Mail Address: | 9040 Town Center Parkway, Lakewood Ranch, FL 34202 |
| ZIP code: | 34202 |
| County: | Manatee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1124840038 | 2024-10-30 | 2024-10-30 | 9040 TOWN CENTER PKWY, LAKEWOOD RANCH, FL, 342024101, US | 9040 TOWN CENTER PKWY, LAKEWOOD RANCH, FL, 342024101, US | |||||||||||||||||||||
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| Phone | +1 941-877-0284 |
Authorized person
| Name | DR. VALERIE ROTH |
| Role | CO-OWNER |
| Phone | 9418770284 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | No |
| Taxonomy Code | 103TS0200X - School Psychologist |
| Is Primary | Yes |
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| ROTH, Peter R | Agent | 11519 Pimpernel Dr, BRADENTON, FL 34202 |
| Name | Role | Address |
|---|---|---|
| ROTH, VALERIE N | Authorized Member | 11519 Pimpernel Dr, BRADENTON, FL 34202 |
| Mahiquez, Desiree | Authorized Member | 16031 Tradewind Ter, Bradenton, FL 34211 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-02-14 | ROTH, Peter R | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-07-20 | 11519 Pimpernel Dr, BRADENTON, FL 34202 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2019-04-29 | 9040 Town Center Parkway, Lakewood Ranch, FL 34202 | No data |
| CHANGE OF MAILING ADDRESS | 2019-04-29 | 9040 Town Center Parkway, Lakewood Ranch, FL 34202 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-14 |
| ANNUAL REPORT | 2024-02-14 |
| ANNUAL REPORT | 2023-01-28 |
| ANNUAL REPORT | 2022-02-27 |
| ANNUAL REPORT | 2021-04-25 |
| ANNUAL REPORT | 2020-07-20 |
| ANNUAL REPORT | 2019-04-29 |
| Florida Limited Liability | 2018-01-02 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 7816307409 | 2020-05-17 | 0455 | PPP | 9040 Town Center Parkway, Bradenton, FL, 34202 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 17 Feb 2025
Sources: Florida Department of State
