| Entity Name: | COASTAL COUNSELING PCB, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 02 Mar 2018 (7 years ago) |
| Date of dissolution: | 25 Sep 2020 (4 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2020 (4 years ago) |
| Document Number: | L18000055895 |
| FEI/EIN Number | 82-4698417 |
| Address: | 2522 PELICAN BAY DRIVE, PANAMA CITY BEACH, FL 32408 |
| Mail Address: | 2522 PELICAN BAY DRIVE, PANAMA CITY BEACH, FL 32408 |
| ZIP code: | 32408 |
| County: | Bay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1730676057 | 2018-04-23 | 2018-04-23 | 2522 PELICAN BAY DR, PANAMA CITY BEACH, FL, 324087046, US | 400 THOMAS DR., 7108, PANAMA CITY BEACH, FL, 32408, US | |||||||||||||||||
|
|||||||||||||||||||||
| Phone | +1 850-733-7720 |
Authorized person
| Name | DR. TREGON FITCH |
| Role | MANAGER/COUNSELOR |
| Phone | 8507337720 |
Taxonomy
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | 11097 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| FITCH, TREGON | Agent | 2522 PELICAN BAY DRIVE, PANAMA CITY BEACH, FL 32408 |
| Name | Role | Address |
|---|---|---|
| FITCH, TREGON | Managing Member | 2522 PELICAN BAY DRIVE, PANAMA CITY BEACH, FL 32408 |
| MARSHALL, JENNIFER L | Managing Member | 2522 PELICAN BAY DRIVE, PANAMA CITY BEACH, FL 32408 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2019-04-01 |
| Florida Limited Liability | 2018-03-02 |
Date of last update: 18 Jan 2025
Sources: Florida Department of State
