| Entity Name: | SOUTH BAY COUNSELING, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 03 Oct 2019 (5 years ago) |
| Document Number: | L19000249031 |
| FEI/EIN Number | 84-3248250 |
| Address: | 275 4th Street North, Saint Petersburg, FL 33701 |
| Mail Address: | 212 3rd Street North, SAINT PETERSBURG, FL 33701 |
| ZIP code: | 33701 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1710591383 | 2020-09-01 | 2020-09-01 | 5995 DR MARTIN LUTHER KING JR ST S, SAINT PETERSBURG, FL, 337055541, US | 5995 DR MARTIN LUTHER KING JR ST S, SAINT PETERSBURG, FL, 337055541, US | |||||||||||||||||||||
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| Phone | +1 727-698-0624 |
| Fax | 7278672556 |
Authorized person
| Name | JOHN ANDREW BELL |
| Role | OWNER/MANAGER |
| Phone | 7276980624 |
Taxonomy
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | STATE LICENSE |
| Number | SW6542 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BELL, JOHN A | Agent | 212 3rd Street North, SAINT PETERSBURG, FL 33701 |
| Name | Role | Address |
|---|---|---|
| BELL, JOHN A | Manager | 212 3rd Street North, SAINT PETERSBURG, FL 33701 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-01-31 | 275 4th Street North, Saint Petersburg, FL 33701 | No data |
| CHANGE OF MAILING ADDRESS | 2024-01-31 | 275 4th Street North, Saint Petersburg, FL 33701 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-01-31 | 212 3rd Street North, SAINT PETERSBURG, FL 33701 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-31 |
| ANNUAL REPORT | 2023-01-30 |
| ANNUAL REPORT | 2022-03-14 |
| ANNUAL REPORT | 2021-02-11 |
| ANNUAL REPORT | 2020-02-03 |
| Florida Limited Liability | 2019-10-03 |
Date of last update: 16 Jan 2025
Sources: Florida Department of State
