| Entity Name: | MASTERPIECE COUNSELING & WELLNESS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 14 Jan 2019 (6 years ago) |
| Last Event: | LC STMNT OF RA/RO CHG |
| Event Date Filed: | 10 Oct 2019 (5 years ago) |
| Document Number: | L19000014621 |
| FEI/EIN Number | 83-3191716 |
| Address: | 703 cloverleaf blvd, DELTONA, FL, 32725, US |
| Mail Address: | 703 CLOVERLEAF BLVD., DELTONA, FL, 32725, US |
| ZIP code: | 32725 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1891259313 | 2019-01-29 | 2024-11-01 | 703 CLOVERLEAF BLVD, DELTONA, FL, 327258809, US | 703 CLOVERLEAF BLVD, DELTONA, FL, 327258809, US | |||||||||||||||||||
|
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| Phone | +1 321-297-1408 |
Authorized person
| Name | ELIZABETH SANCHEZ |
| Role | MANAGER |
| Phone | 3212971408 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1366677080 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SANCHEZ ELIZABETH | Agent | 703 CLOVERLEAF BLVD, DELTONA, FL, 32725 |
| Name | Role | Address |
|---|---|---|
| SANCHEZ ELIZABETH | Manager | 703 CLOVERLEAF BLVD., DELTONA, FL, 32725 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2020-05-18 | 703 cloverleaf blvd, DELTONA, FL 32725 | No data |
| CHANGE OF MAILING ADDRESS | 2019-10-31 | 703 cloverleaf blvd, DELTONA, FL 32725 | No data |
| LC STMNT OF RA/RO CHG | 2019-10-10 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-10-10 | 703 CLOVERLEAF BLVD, DELTONA, FL 32725 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-07 |
| ANNUAL REPORT | 2023-03-04 |
| ANNUAL REPORT | 2022-04-24 |
| ANNUAL REPORT | 2021-04-21 |
| ANNUAL REPORT | 2020-06-08 |
| CORLCRACHG | 2019-10-10 |
| Florida Limited Liability | 2019-01-14 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
