| Entity Name: | MINDWORKS INTEGRATIVE PSYCHOLOGY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 06 Nov 2018 (6 years ago) |
| Document Number: | L18000257933 |
| FEI/EIN Number | 832447937 |
| Address: | 8461 LAKE WORTH RD, LAKE WORTH, FL, 33467, US |
| Mail Address: | 8461 LAKE WORTH RD, LAKE WORTH, FL, 33467, US |
| ZIP code: | 33467 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1528683364 | 2020-06-08 | 2020-06-08 | 8461 LAKE WORTH RD STE 113, LAKE WORTH, FL, 334672474, US | 8461 LAKE WORTH RD STE 113, LAKE WORTH, FL, 334672474, US | |||||||||||||
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| Phone | +1 561-223-4111 |
Authorized person
| Name | DR. TIMOTHY EAGAN |
| Role | LICENSED PSYCHOLOGIST |
| Phone | 5612234111 |
Taxonomy
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| FRIEDBERG MELVIN B | Agent | Altman Friedberg & Wolfman, PLLC, BOYNTON BEACH, FL, 33426 |
| Name | Role | Address |
|---|---|---|
| EAGAN TIMOTHY B | Manager | 8461 LAKE WORTH RD, LAKE WORTH, FL, 33467 |
| WEISSBLATT LARA | Manager | 8461 LAKE WORTH RD, LAKE WORTH, FL, 33467 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-03-27 | 8461 LAKE WORTH RD, Suite 451, LAKE WORTH, FL 33467 | No data |
| CHANGE OF MAILING ADDRESS | 2024-03-27 | 8461 LAKE WORTH RD, Suite 451, LAKE WORTH, FL 33467 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-03-15 | Altman Friedberg & Wolfman, PLLC, 1800 N Congress Ave, Suite 307, BOYNTON BEACH, FL 33426 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-27 |
| ANNUAL REPORT | 2023-03-01 |
| ANNUAL REPORT | 2022-03-05 |
| ANNUAL REPORT | 2021-03-15 |
| ANNUAL REPORT | 2020-03-31 |
| ANNUAL REPORT | 2019-01-11 |
| Florida Limited Liability | 2018-11-06 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
