| Entity Name: | PSYCHOTHERAPY SERVICES BY GAIL BRONSTEIN DECINA LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 12 May 2022 (3 years ago) |
| Document Number: | L22000223306 |
| FEI/EIN Number | 88-2495366 |
| Address: | 17 WILLOWBROOK LANE #102, DELRAY BEACH, FL, 33446, US |
| Mail Address: | 17 WILLOWBROOK LANE #102, DELRAY BEACH, FL, 33446, US |
| ZIP code: | 33446 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1750007043 | 2022-10-18 | 2024-08-01 | 17 WILLOWBROOK LN APT 102, DELRAY BEACH, FL, 334461644, US | 17 WILLOWBROOK LN APT 102, DELRAY BEACH, FL, 334461644, US | |||||||||||||||
|
|||||||||||||||||||
| Phone | +1 954-540-7415 |
| Phone | +1 561-556-2738 |
Authorized person
| Name | GAIL DECINA |
| Role | PROVIDER/OWNER |
| Phone | 5495407415 |
Taxonomy
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| ENRIQUEZ STEPHEN | Agent | 17 WILLOWBROOKE LANE #102, DELRAY BEACH, FL, 33446 |
| Name | Role | Address |
|---|---|---|
| BRONSTEIN DECINA GAIL | Managing Member | 17 WILLOWBROOKE LANE #102, DELRAY BEACH, FL, 33446 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-06-09 | 17 WILLOWBROOK LANE #102, DELRAY BEACH, FL 33446 | No data |
| CHANGE OF MAILING ADDRESS | 2022-06-09 | 17 WILLOWBROOK LANE #102, DELRAY BEACH, FL 33446 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-09 |
| ANNUAL REPORT | 2023-03-09 |
| Florida Limited Liability | 2022-05-12 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
