| Entity Name: | MCCLELLAN COUNSELING LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 08 Mar 2021 (4 years ago) |
| Document Number: | L21000109967 |
| FEI/EIN Number | 87-1713795 |
| Address: | 2001 PALM BEACH LAKES BOULEVARD, WEST PALM BEACH, FL, 33409, US |
| Mail Address: | 701 38TH ST, WEST PALM BEACH, FL, 33407, US |
| ZIP code: | 33409 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1528631660 | 2021-07-16 | 2021-07-16 | 701 38TH ST, WEST PALM BEACH, FL, 334074105, US | 2001 PALM BEACH LAKES BLVD, WEST PALM BEACH, FL, 334096510, US | |||||||||||||||||
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| Phone | +1 630-229-8300 |
Authorized person
| Name | MR. JASON DANIEL MCCLELLAN |
| Role | CLINICAL MENTAL HEALTH THERAPIST |
| Phone | 6302298300 |
Taxonomy
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NPI |
| Number | 1437722568 |
| Name | Role | Address |
|---|---|---|
| MCCLELLAN JASON D | Agent | 701 38TH ST, WEST PALM BEACH, FL, 33407 |
| Name | Role | Address |
|---|---|---|
| McClellan Jason DMr | Owne | 2001 PALM BEACH LAKES BOULEVARD, WEST PALM BEACH, FL, 33409 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-07-20 | 2001 PALM BEACH LAKES BOULEVARD, WEST PALM BEACH, FL 33409 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-09 |
| ANNUAL REPORT | 2023-02-01 |
| ANNUAL REPORT | 2022-01-20 |
| Florida Limited Liability | 2021-03-08 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
