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MTB THERAPIST LLC - Florida Company Profile

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Company Details

Entity Name: MTB THERAPIST LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 05 Jan 2018 (8 years ago)
Last Event: REINSTATEMENT
Event Date Filed: 01 Feb 2020 (6 years ago)
Document Number: L18000004480
FEI/EIN Number 82-3930984
Address: 3452 LIVE OAK HOLLOW DR, ORANGE PARK, FL, 32065, US
Mail Address: 3452 LIVE OAK HOLLOW DR, ORANGE PARK, FL, 32065, US
ZIP code: 32065
City: Orange Park
County: Clay
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
BAKER MERLAND Manager 3452 LIVE OAK HOLLOW DR, ORANGE PARK, FL, 32065
BAKER MERLAND Agent 3452 LIVE OAK HOLLOW DR, ORANGE PARK, FL, 32065

Unique Entity ID

CAGE Code:
8CQZ0
UEI Expiration Date:
2020-07-14

Business Information

Activation Date:
2019-08-04
Initial Registration Date:
2019-06-20

Commercial and government entity program

CAGE number:
8CQZ0
Status:
Active
Type:
Non-Manufacturer
CAGE Update Date:
2024-08-30
CAGE Expiration:
2028-09-04
SAM Expiration:
2024-08-30

Contact Information

POC:
MERLAND BAKER

National Provider Identifier

NPI Number:
1003314790
Certification Date:
2025-04-22

Authorized Person:

Name:
MERLAND BAKER
Role:
DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
101Y00000X - Counselor
Is Primary:
No
Selected Taxonomy:
101YA0400X - Addiction (Substance Use Disorder) Counselor
Is Primary:
No
Selected Taxonomy:
101YM0800X - Mental Health Counselor
Is Primary:
No
Selected Taxonomy:
101YP2500X - Professional Counselor
Is Primary:
Yes

Contacts:

Fax:
9043230469

Events

Event Type Filed Date Value Description
REINSTATEMENT 2020-02-01 - -
REGISTERED AGENT NAME CHANGED 2020-02-01 BAKER, MERLAND -
ADMIN DISSOLUTION FOR ANNUAL REPORT 2019-09-27 - -

Documents

Name Date
ANNUAL REPORT 2024-04-26
ANNUAL REPORT 2023-09-08
ANNUAL REPORT 2022-04-27
ANNUAL REPORT 2021-04-06
REINSTATEMENT 2020-02-01
Florida Limited Liability 2018-01-05

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Date of last update: 01 Aug 2025

Sources: Florida Department of State