| Entity Name: | CREATIVE PATH COUNSELING LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 12 Apr 2021 (4 years ago) |
| Document Number: | L21000169184 |
| FEI/EIN Number | 86-3630515 |
| Address: | 16069 TAMPA ST, BROKSVILLE, FL, 34604, US |
| Mail Address: | 16069 TAMPA ST, BROKSVILLE, FL, 34604, US |
| ZIP code: | 34604 |
| County: | Hernando |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1629652078 | 2021-05-11 | 2021-05-11 | 16069 TAMPA ST, BROOKSVILLE, FL, 346048458, US | 16069 TAMPA ST, BROOKSVILLE, FL, 346048458, US | |||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||
| Phone | +1 203-706-9325 |
Authorized person
| Name | MS. LINA LACASSE |
| Role | PRESIDENT |
| Phone | 2037069325 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | No |
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| Is Primary | No |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | FLORIDA DRIVER LICENSE |
| Number | L220-520-68-662-0 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LACASSE LINA | Agent | 16069 TAMPA ST, BROOKSVILLE, FL, 34604 |
| Name | Role | Address |
|---|---|---|
| LACASSE LINA | Manager | 16069 TAMA ST, BROOKSVILLE, FL, 34604 |
| Name | Role | Address |
|---|---|---|
| ROGERS ANITA | Authorized Person | 12416 TROUT CICLE, SPRING HILL, FL, 34609 |
| BLOMELING-DEROO SARA | Authorized Person | 4157 OASIS AVE, SPRING HILL, FL, 34609 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-20 |
| ANNUAL REPORT | 2023-03-13 |
| ANNUAL REPORT | 2022-04-19 |
| Florida Limited Liability | 2021-04-12 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
