| Entity Name: | BROOKE COUNSELING SERVICES PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 27 Feb 2019 (6 years ago) |
| Document Number: | L19000057971 |
| FEI/EIN Number | 83-3904819 |
| Address: | 2452 Moultrie Rd, SAINT AUGUSTINE, FL, 32086, US |
| Mail Address: | PO Box 806, SAINT AUGUSTINE, FL, 32085, US |
| ZIP code: | 32086 |
| County: | St. Johns |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1063974806 | 2019-04-02 | 2019-04-02 | 4475 US HIGHWAY 1 S STE 608, SAINT AUGUSTINE, FL, 320867282, US | 4475 US HIGHWAY 1 S STE 608, SAINT AUGUSTINE, FL, 320867282, US | |||||||||||||
|
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| Phone | +1 904-447-7525 |
Authorized person
| Name | JACQUELINE DOUGHERTY |
| Role | OWNER |
| Phone | 9044477525 |
Taxonomy
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Dougherty Jacqueline | Agent | 2450 Old Moultrie Rd #202, St. Augustine,, St. Augustine, FL, 32084 |
| Name | Role | Address |
|---|---|---|
| DOUGHERTY JACQUELINE | Authorized Member | PO Box 806, SAINT AUGUSTINE, FL, 32085 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G19000115708 | ANCIENT CITY WELLNESS | EXPIRED | 2019-10-25 | 2024-12-31 | No data | P.O.BOX 225 ST, ST. AUGUSTINE, FL, 32085 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2024-04-29 | 2452 Moultrie Rd, SAINT AUGUSTINE, FL 32086 | No data |
| REGISTERED AGENT NAME CHANGED | 2024-04-29 | Dougherty, Jacqueline | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-29 | 2450 Old Moultrie Rd #202, St. Augustine, FL 32086, St. Augustine, FL 32084 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-02-16 | 2452 Moultrie Rd, SAINT AUGUSTINE, FL 32086 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-29 |
| AMENDED ANNUAL REPORT | 2023-10-25 |
| ANNUAL REPORT | 2023-02-16 |
| ANNUAL REPORT | 2022-01-29 |
| ANNUAL REPORT | 2021-01-13 |
| ANNUAL REPORT | 2020-04-01 |
| Florida Limited Liability | 2019-02-27 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
