| Entity Name: | LAKE NEURODIVERSITY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 06 Feb 2023 (2 years ago) |
| Document Number: | L23000065071 |
| FEI/EIN Number | 92-2629916 |
| Mail Address: | 12501 LAKE RIDGE CIRCLE, CLERMONT, FL 34711 |
| Address: | 711 W Main Str, LEESBURG, FL 34748 |
| ZIP code: | 34748 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1790544658 | 2024-03-14 | 2024-03-14 | 711 W MAIN ST STE 127, LEESBURG, FL, 347485128, US | 711 W MAIN ST STE 127, LEESBURG, FL, 347485128, US | |||||||||||||
|
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| Phone | +1 352-460-1925 |
Authorized person
| Name | DR. SUSAN ANDREWS |
| Role | CO-OWNER, PSYCHOLOGIST |
| Phone | 3523486989 |
Taxonomy
| Taxonomy Code | 103TS0200X - School Psychologist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| JOYNER, MELISSA H | Agent | 12501 LAKE RIDGE CIRCLE, CLERMONT, FL 34711 |
| Name | Role | Address |
|---|---|---|
| JOYNER, MELISSA H | Manager | 12501 LAKE RIDGE CIRCLE, CLERMONT, FL 34711 |
| Andrews, Susan M | Manager | 3347 Logan Berry Dr., Mount Dora, FL 32757 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2025-02-06 | 711 W Main Str, LEESBURG, FL 34748 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-07-28 | 117 N 7th Street, LEESBURG, FL 34748 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-02-06 |
| ANNUAL REPORT | 2024-01-29 |
| Florida Limited Liability | 2023-02-06 |
Date of last update: 10 Feb 2025
Sources: Florida Department of State
