| Entity Name: | MODERN MENTAL HEALTH, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 10 Apr 2019 (6 years ago) |
| Document Number: | L19000098981 |
| FEI/EIN Number | 83-4454219 |
| Address: | 9079 4th Street N, Saint Petersburg, FL, 33702, US |
| Mail Address: | 9079 4th Street N, SAINT PETERSBURG, FL, 33702, US |
| ZIP code: | 33702 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1487271763 | 2020-07-02 | 2020-07-02 | 1221 34TH AVE N, ST PETERSBURG, FL, 337041842, US | 3000 GULF TO BAY BLVD STE 312, CLEARWATER, FL, 337594304, US | |||||||||||||||||||
|
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| Phone | +1 848-299-9329 |
| Phone | +1 727-279-0101 |
Authorized person
| Name | JACLYN MATTHEWS |
| Role | OWNER |
| Phone | 8482999329 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | No |
| Taxonomy Code | 103TP2701X - Group Psychotherapy Psychologist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MATTHEWS JACLYN | Agent | 9079 4th Street N, SAINT PETERSBURG, FL, 33702 |
| Name | Role | Address |
|---|---|---|
| MATTHEWS JACLYN | Manager | 9079 4th Street N, SAINT PETERSBURG, FL, 33702 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2022-01-21 | 9079 4th Street N, SAINT PETERSBURG, FL 33702 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-10-05 | 9079 4th Street N, Saint Petersburg, FL 33702 | No data |
| CHANGE OF MAILING ADDRESS | 2021-10-05 | 9079 4th Street N, Saint Petersburg, FL 33702 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-06 |
| ANNUAL REPORT | 2024-02-04 |
| ANNUAL REPORT | 2023-01-22 |
| ANNUAL REPORT | 2022-01-21 |
| ANNUAL REPORT | 2021-01-13 |
| ANNUAL REPORT | 2020-02-24 |
| Florida Limited Liability | 2019-04-10 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
