| Entity Name: | COURTNEY CAVALL, LMHC LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 16 Jul 2020 (5 years ago) |
| Document Number: | L20000206079 |
| FEI/EIN Number | 85-2240341 |
| Address: | 4803 SEABERG RD., ZEPHYRHILLS, FL 33541 |
| Mail Address: | 4803 SEABERG RD., ZEPHYRHILLS, FL 33541 |
| ZIP code: | 33541 |
| County: | Pasco |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1255941209 | 2020-08-05 | 2021-01-14 | 4803 SEABERG RD, ZEPHYRHILLS, FL, 335412862, US | 4803 SEABERG RD, ZEPHYRHILLS, FL, 335412862, US | |||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 954-649-6592 |
Authorized person
| Name | COURTNEY CAVALL |
| Role | MBR |
| Phone | 9546496592 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | Yes |
| Taxonomy Code | 103TP2701X - Group Psychotherapy Psychologist |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 024475500 |
| State | FL |
| Issuer | MEDICAID |
| Number | 024451900 |
| State | FL |
| Issuer | LICENSED MENTAL HEALTH COUNSELOR, LMHC, MH 10216. FLORIDA DEPARTMENT OF HEALTH |
| Number | 590688286 |
| State | FL |
| Issuer | MEDICAID |
| Number | 108005400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CAVALL, LYNN | Agent | 36724 JEFFERSON AVE., DADE CITY, FL 33523 |
| Name | Role | Address |
|---|---|---|
| CAVALL, COURTNEY | Manager | 4803 SEABERG RD., ZEPHYRHILLS, FL 33541 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-04 |
| ANNUAL REPORT | 2023-01-26 |
| ANNUAL REPORT | 2022-01-27 |
| ANNUAL REPORT | 2021-01-11 |
| Florida Limited Liability | 2020-07-16 |
Date of last update: 15 Jan 2025
Sources: Florida Department of State
