| Entity Name: | FAMILY PSYCHOLOGICAL SERVICES OF LAKELAND LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 12 Apr 2018 (7 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 14 Oct 2019 (5 years ago) |
| Document Number: | L18000092455 |
| FEI/EIN Number | 82-5265269 |
| Address: | 107 MORNINGSIDE DRIVE, SUITE C, LAKELAND, FL, 33803 |
| Mail Address: | 107 MORNINGSIDE DRIVE, SUITE C, LAKELAND, FL, 33803 |
| ZIP code: | 33803 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1265911382 | 2018-08-09 | 2018-08-09 | 107 MORNINGSIDE DR STE C, LAKELAND, FL, 338032600, US | 107 MORNINGSIDE DR STE C, LAKELAND, FL, 338032600, US | |||||||||||||||||||
|
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| Phone | +1 863-606-6001 |
| Fax | 8636066002 |
Authorized person
| Name | MRS. ELIZABETH DUMVILLE |
| Role | OWNER/PROVIDER |
| Phone | 8636066001 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| License Number | MH6514 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| DUMVILLE ELIZABETH L | Agent | 107 Morningside Dr, LAKELAND,, FL, 33803 |
| Name | Role | Address |
|---|---|---|
| Dumville Elizabeth L | owne | 107 MORNINGSIDE DRIVE, LAKELAND, FL, 33803 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2019-10-14 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2019-10-14 | DUMVILLE, ELIZABETH L | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-10-14 | 107 Morningside Dr, Suite C, LAKELAND,, FL 33803 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-01 |
| ANNUAL REPORT | 2023-02-01 |
| ANNUAL REPORT | 2022-04-25 |
| ANNUAL REPORT | 2021-04-02 |
| ANNUAL REPORT | 2020-03-25 |
| REINSTATEMENT | 2019-10-14 |
| Florida Limited Liability | 2018-04-12 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
