| Entity Name: | BEACON PSYCHIATRY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 04 Dec 2020 (4 years ago) |
| Document Number: | L20000379957 |
| FEI/EIN Number | 85-4382732 |
| Address: | 8141 Bellarus Way, Suite 103, Trinity, FL 34655 |
| Mail Address: | 8141 Bellarus Way, Suite 103, Trinity, FL 34655 |
| ZIP code: | 34655 |
| County: | Pasco |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1578140257 | 2021-03-27 | 2021-03-27 | 3610 GALILEO DR STE 101, TRINITY, FL, 346551794, US | 3610 GALILEO DR STE 101, TRINITY, FL, 346551794, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 727-456-9135 |
| Fax | 7274569134 |
Authorized person
| Name | DR. LINH PHUONG THI DINH |
| Role | OWNER/MEDICAL DIRECTOR |
| Phone | 7277935558 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | No |
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| Is Primary | No |
| Taxonomy Code | 106H00000X - Marriage & Family Therapist |
| Is Primary | No |
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| Is Primary | Yes |
| Taxonomy Code | 363A00000X - Physician Assistant |
| Is Primary | No |
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| DINH, LINH PHUONG T, MD | Agent | 8141 Bellarus Way, SUITE 103, TRINITY, FL 34655 |
| Name | Role | Address |
|---|---|---|
| Dinh, Linh Phuong THI, MD | President | 8141 Bellarus Way, STE 103 Trinity, FL 34655 |
| Name | Role | Address |
|---|---|---|
| Dinh, Linh Phuong THI, MD | Manager | 8141 Bellarus Way, STE 103 Trinity, FL 34655 |
| Name | Role | Address |
|---|---|---|
| Dinh, Linh Phuong THI, MD | Chief Executive Officer | 8141 Bellarus Way, STE 103 Trinity, FL 34655 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2024-02-07 | 8141 Bellarus Way, SUITE 103, TRINITY, FL 34655 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-01-29 | 8141 Bellarus Way, Suite 103, Trinity, FL 34655 | No data |
| CHANGE OF MAILING ADDRESS | 2023-01-29 | 8141 Bellarus Way, Suite 103, Trinity, FL 34655 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-07 |
| ANNUAL REPORT | 2023-01-29 |
| ANNUAL REPORT | 2022-04-12 |
| Florida Limited Liability | 2020-12-04 |
Date of last update: 14 Feb 2025
Sources: Florida Department of State
