| Entity Name: | GRACE HOPE COUNSELING OF FLORIDA, PLLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 16 Sep 2019 (5 years ago) |
| Last Event: | LC NAME CHANGE |
| Event Date Filed: | 01 Sep 2022 (2 years ago) |
| Document Number: | L19000233717 |
| FEI/EIN Number | 84-3168745 |
| Address: | 99 6TH STREET SW,, WINTER HAVEN, FL, 33880, US |
| Mail Address: | 99 6TH STREET SW,, WINTER HAVEN, FL, 33880, US |
| ZIP code: | 33880 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1013559012 | 2019-10-10 | 2023-06-05 | 111 W CENTRAL AVE # 956, WINTER HAVEN, FL, 338808001, US | 99 6TH ST SW STE 101, WINTER HAVEN, FL, 338807902, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 863-210-9473 |
| Fax | 8635883152 |
| Phone | +1 863-662-4191 |
Authorized person
| Name | NAKITA WATKINS SCOTT |
| Role | EXECUTIVE CLINICAL DIRECTOR |
| Phone | 8636624191 |
Taxonomy
| Taxonomy Code | 101Y00000X - Counselor |
| Is Primary | No |
| Taxonomy Code | 101YP1600X - Pastoral Counselor |
| Is Primary | No |
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| Is Primary | Yes |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | No |
Other Provider Identifiers
| Issuer | LCSW |
| Number | 1326315979 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SCOTT NAKITA W | Agent | 1044 BRENTON MANOR DRIVE, WINTER HAVEN, FL, 33881 |
| Name | Role | Address |
|---|---|---|
| SCOTT NAKITA W | Chief Executive Officer | 1044 BRENTON MANOR DRIVE, WINTER HAVEN, FL, 33881 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2025-06-01 | 99 6TH STREET SW,, SUITE 101, WINTER HAVEN, FL 33880 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2024-06-01 | 99 6TH STREET SW,, SUITE 101, WINTER HAVEN, FL 33880 | No data |
| CHANGE OF MAILING ADDRESS | 2024-05-01 | 99 6TH STREET SW,, SUITE 101, WINTER HAVEN, FL 33880 | No data |
| LC NAME CHANGE | 2022-09-01 | GRACE HOPE COUNSELING OF FLORIDA, PLLC | No data |
| REGISTERED AGENT NAME CHANGED | 2021-02-15 | SCOTT, NAKITA WATKINS | No data |
| LC AMENDMENT | 2020-07-14 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-05-01 |
| ANNUAL REPORT | 2023-04-30 |
| LC Name Change | 2022-09-01 |
| ANNUAL REPORT | 2022-04-18 |
| ANNUAL REPORT | 2021-02-15 |
| LC Amendment | 2020-07-14 |
| ANNUAL REPORT | 2020-03-19 |
| Florida Limited Liability | 2019-09-16 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
