| Entity Name: | KAAFI COUNSELING LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 07 Oct 2019 (5 years ago) |
| Document Number: | L19000252387 |
| FEI/EIN Number | 83-2050575 |
| Mail Address: | 1499 FOREST HILL BLVD, WEST PALM BEACH, FL, 33406, US |
| Address: | 1499 FOREST HILL BLVD, SUITE 115, WEST PALM BEACH, FL, 33406, US |
| ZIP code: | 33406 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1508590076 | 2022-07-12 | 2022-07-12 | 1499 FOREST HILL BLVD STE 115, WEST PALM BEACH, FL, 334066050, US | 1499 FOREST HILL BLVD STE 115, WEST PALM BEACH, FL, 334066050, US | |||||||||||||||||||||||
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| Phone | +1 561-463-0884 |
| Fax | 8773179406 |
Authorized person
| Name | FARTUN S MOHAMUD |
| Role | OWNER AND CLINIC DIRECTOR |
| Phone | 5614630884 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | No |
| Taxonomy Code | 103T00000X - Psychologist |
| Is Primary | No |
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KAAFI COUNSELING 401(K) PLAN | 2023 | 832050575 | 2024-05-07 | KAAFI COUNSELING, LLC | 2 | |||||||||||||||||||||||||||||||
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| Administrator’s EIN | 474474775 |
| Plan administrator’s name | GUIDELINE, INC. |
| Plan administrator’s address | 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010 |
| Administrator’s telephone number | 8882283491 |
Signature of
| Role | Plan administrator |
| Date | 2024-05-07 |
| Name of individual signing | QIAN LIU |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2022-01-01 |
| Business code | 621330 |
| Sponsor’s telephone number | 5614630884 |
| Plan sponsor’s address | 1499 FOREST HILL BLVD, SUITE 115, WEST PALM BEACH, FL, 33406 |
Plan administrator’s name and address
| Administrator’s EIN | 474474775 |
| Plan administrator’s name | GUIDELINE, INC. |
| Plan administrator’s address | 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010 |
| Administrator’s telephone number | 8882283491 |
Signature of
| Role | Plan administrator |
| Date | 2023-05-30 |
| Name of individual signing | CHRISTINE RIMER |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role |
|---|---|
| ROCKET LAWYER CORPORATE SERVICES LLC | Agent |
| Name | Role | Address |
|---|---|---|
| MOHAMUD FARTUN Dr. | Authorized Member | 1499 FOREST HILL BLVD, WEST PALM BEACH, FL, 33406 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-01-29 | 1499 FOREST HILL BLVD, SUITE 115, WEST PALM BEACH, FL 33406 | No data |
| CHANGE OF MAILING ADDRESS | 2023-01-29 | 1499 FOREST HILL BLVD, SUITE 115, WEST PALM BEACH, FL 33406 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-27 |
| ANNUAL REPORT | 2023-01-29 |
| ANNUAL REPORT | 2022-01-24 |
| ANNUAL REPORT | 2021-02-11 |
| ANNUAL REPORT | 2020-06-15 |
| Florida Limited Liability | 2019-10-07 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
