| Entity Name: | EMBODIED PRACTICE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 04 Dec 2023 (a year ago) |
| Document Number: | L23000537721 |
| FEI/EIN Number | 93-4674971 |
| Address: | 4300 Bayou Blvd, Ste. 25B, PENSACOLA, FL 32503 |
| Mail Address: | 1759 Waterbury Way, Cantonment, FL 32533 |
| ZIP code: | 32503 |
| County: | Escambia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1245063304 | 2024-08-23 | 2024-08-29 | 1759 WATERBURY WAY, CANTONMENT, FL, 325338414, US | 600 UNIVERSITY BLVD, BLDG 7 STE 5, PENSACOLA, FL, 32504, US | |||||||||||||
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| Phone | +1 850-390-4213 |
Authorized person
| Name | LAUREN SOUTULLO |
| Role | OWNER |
| Phone | 8503904213 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| SOUTULLO, LAUREN | Agent | 4300 Bayou Blvd, Ste. 25B, PENSACOLA, FL 32503 |
| Name | Role | Address |
|---|---|---|
| SOUTULLO, LAUREN | Manager | 4300 Bayou Blvd, Ste. 25B PENSACOLA, FL 32503 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2025-01-13 | 4300 Bayou Blvd, Ste. 25B, PENSACOLA, FL 32503 | No data |
| CHANGE OF MAILING ADDRESS | 2025-01-13 | 4300 Bayou Blvd, Ste. 25B, PENSACOLA, FL 32503 | No data |
| REGISTERED AGENT NAME CHANGED | 2025-01-13 | SOUTULLO, LAUREN | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2025-01-13 | 4300 Bayou Blvd, Ste. 25B, PENSACOLA, FL 32503 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-13 |
| ANNUAL REPORT | 2024-02-06 |
| Florida Limited Liability | 2023-12-04 |
Date of last update: 09 Feb 2025
Sources: Florida Department of State
