| Entity Name: | AUTHENTIC SELF COUNSELING OF JACKSONVILLE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 09 May 2018 (7 years ago) |
| Document Number: | L18000116234 |
| FEI/EIN Number | 83-1653167 |
| Address: | 3733 UNIVERSITY BLVD W., JACKSONVILLE, FL, 32217, US |
| Mail Address: | 3733 UNIVERSITY BLVD W., JACKSONVILLE, FL, 32217, US |
| ZIP code: | 32217 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1982369625 | 2021-11-08 | 2021-11-08 | 910 S 8TH ST STE 100, FERNANDINA BEACH, FL, 320343745, US | 910 S 8TH ST STE 100, FERNANDINA BEACH, FL, 320343745, US | |||||||||||||
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| Phone | +1 904-894-3867 |
Authorized person
| Name | MICHELLE ANDERSON |
| Role | OWNER |
| Phone | 9049907117 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Anderson Michelle LMHC | Agent | 3733 UNIVERSITY BLVD W., #203, JACKSONVILLE, FL, 32217 |
| Name | Role | Address |
|---|---|---|
| Green Katherine ALMHC | Manager | 3733 University Blvd W Ste 203, Jacksonville, FL, 32217 |
| Anderson Michelle ALMHC | Manager | 3733 University Blvd W, JACKSONVILLE, FL, 32217 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2023-05-19 | 3733 UNIVERSITY BLVD W., #203, JACKSONVILLE, FL 32217 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-08-04 | 3733 UNIVERSITY BLVD W., 203, JACKSONVILLE, FL 32217 | No data |
| CHANGE OF MAILING ADDRESS | 2022-08-04 | 3733 UNIVERSITY BLVD W., 203, JACKSONVILLE, FL 32217 | No data |
| REGISTERED AGENT NAME CHANGED | 2021-05-18 | Anderson, Michelle, LMHC | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-31 |
| ANNUAL REPORT | 2023-05-19 |
| ANNUAL REPORT | 2022-08-04 |
| ANNUAL REPORT | 2021-05-18 |
| ANNUAL REPORT | 2020-09-25 |
| ANNUAL REPORT | 2019-06-17 |
| Florida Limited Liability | 2018-05-09 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
