| Entity Name: | DNA PEDIATRIC COUNSELING SERVICES & RESOURCES "LLC" |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 09 Apr 2019 (6 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 30 Apr 2023 (2 years ago) |
| Document Number: | L19000097616 |
| FEI/EIN Number | 83-4652629 |
| Address: | 9351 East heather lane, MIRAMAR, FL, 33025, US |
| Mail Address: | 2413 Main st Box 545, MIRAMAR, FL, 33025, US |
| ZIP code: | 33025 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1083349948 | 2022-07-23 | 2022-07-23 | 2413 MAIN ST # 545, MIRAMAR, FL, 330257809, US | 9351 E HEATHER LN, MIRAMAR, FL, 330252638, US | |||||||||||||||||||||
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| Phone | +1 305-707-0728 |
| Phone | +1 786-356-9394 |
Authorized person
| Name | SHIRLEY MATHIEU |
| Role | OWNER/THERAPIST |
| Phone | 7863569394 |
Taxonomy
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1295273779 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MATHIEU SHIRLEY | Agent | 9351 EAST HEATHER LANE, MIRAMAR, FL, 33025 |
| Name | Role | Address |
|---|---|---|
| MATHIEU SHIRLEY N | Authorized Representative | 9351 EAST HEATHER LANE, MIRAMAR, FL, 33025 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000139201 | DNA CONSULTING | ACTIVE | 2024-11-14 | 2029-12-31 | No data | 9351 EAST HEATHER LANE, MIRAMAR, FL, 33025 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2023-04-30 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-04-30 | 9351 East heather lane, MIRAMAR, FL 33025 | No data |
| CHANGE OF MAILING ADDRESS | 2023-04-30 | 9351 East heather lane, MIRAMAR, FL 33025 | No data |
| REGISTERED AGENT NAME CHANGED | 2023-04-30 | MATHIEU, SHIRLEY | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-29 |
| REINSTATEMENT | 2023-04-30 |
| ANNUAL REPORT | 2021-02-26 |
| ANNUAL REPORT | 2020-06-07 |
| Florida Limited Liability | 2019-04-09 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
