| Entity Name: | JACLYN LEWIS-CROSWELL, PSY.D. PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 28 Nov 2018 (6 years ago) |
| Document Number: | L18000275025 |
| FEI/EIN Number | 83-2699193 |
| Address: | 2307 NESSLEWOOD DR., WESLEY CHAPEL, FL, 33543, US |
| Mail Address: | 2307 NESSLEWOOD DR., WESLEY CHAPEL, FL, 33543, US |
| ZIP code: | 33543 |
| County: | Pasco |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1609530831 | 2021-10-25 | 2022-01-12 | 2307 NESSLEWOOD DR, WESLEY CHAPEL, FL, 335435119, US | 13357 N 56TH ST, TAMPA, FL, 336171161, US | |||||||||||||
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| Phone | +1 813-679-6300 |
Authorized person
| Name | DR. JACLYN LEE LEWIS-CROSWELL |
| Role | CEO |
| Phone | 8136796300 |
Taxonomy
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| LEWIS-CROSWELL JACLYN | Agent | 2307 NESSLEWOOD DR, WESLEY CHAPEL, FL, 33543 |
| Name | Role | Address |
|---|---|---|
| LEWIS-CROSWELL JACLYN | Chief Executive Officer | 2307 NESSLEWOOD DR., WESLEY CHAPEL, FL, 33543 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-29 |
| ANNUAL REPORT | 2023-01-08 |
| ANNUAL REPORT | 2022-01-07 |
| ANNUAL REPORT | 2021-01-31 |
| ANNUAL REPORT | 2020-01-19 |
| ANNUAL REPORT | 2019-04-28 |
| Florida Limited Liability | 2018-11-28 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
