| Entity Name: | BEACH STREET COUNSELING, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 06 Mar 2023 (2 years ago) |
| Document Number: | L23000116851 |
| FEI/EIN Number | 92-3111550 |
| Address: | 140 S. BEACH STREET, DAYTONA BEACH, FL, 32114, US |
| Mail Address: | 140 S. BEACH STREET Box 51, DAYTONA BEACH, FL, 32114, US |
| ZIP code: | 32114 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1841072600 | 2023-10-17 | 2023-10-17 | 140 S BEACH ST STE 414, DAYTONA BEACH, FL, 321144472, US | 140 S BEACH ST STE 414, DAYTONA BEACH, FL, 321144472, US | |||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||
| Phone | +1 386-299-0026 |
Authorized person
| Name | JEANNIE JENUWINE |
| Role | OWNER |
| Phone | 3862990026 |
Taxonomy
| Taxonomy Code | 261QM0850X - Adult Mental Health Clinic/Center |
| Is Primary | Yes |
| Taxonomy Code | 261QM0855X - Adolescent and Children Mental Health Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QR0405X - Substance Use Disorder Rehabilitation Clinic/Center |
| Is Primary | No |
Other Provider Identifiers
| Issuer | NPI |
| Number | 1851672646 |
| State | MI |
| Name | Role | Address |
|---|---|---|
| Jenuwine Amanda | Agent | 1200 Floral Springs Blvd., PORT ORANGE, FL, 32129 |
| Name | Role | Address |
|---|---|---|
| JENUWINE JEANNIE | Manager | 140 S. BEACH STREET, DAYTONA BEACH, FL, 32114 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-12-07 | 140 S. BEACH STREET, Suite 415, DAYTONA BEACH, FL 32114 | No data |
| CHANGE OF MAILING ADDRESS | 2024-12-07 | 140 S. BEACH STREET, Suite 415, DAYTONA BEACH, FL 32114 | No data |
| REGISTERED AGENT NAME CHANGED | 2024-12-07 | Jenuwine, Amanda | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-12-07 | 1200 Floral Springs Blvd., Apt. 16103, PORT ORANGE, FL 32129 | No data |
| CHANGE OF MAILING ADDRESS | 2024-02-19 | 140 S. BEACH STREET, SUITE 414, DAYTONA BEACH, FL 32114 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-04-10 | 140 S. BEACH STREET, SUITE 414, DAYTONA BEACH, FL 32114 | No data |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-12-07 |
| ANNUAL REPORT | 2024-02-19 |
| Florida Limited Liability | 2023-03-06 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
