| Entity Name: | VISTA COUNSELING AND WELLNESS LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 22 Jan 2024 (a year ago) |
| Document Number: | L24000040961 |
| Address: | 681 BALLARD DRIVE, MELBOURNE, FL 32935 |
| Mail Address: | 681 BALLARD DRIVE, MELBOURNE, FL 32935 |
| ZIP code: | 32935 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1992554885 | 2024-05-14 | 2024-05-14 | 681 BALLARD DR, MELBOURNE, FL, 329356901, US | 2955 PINEDA PLAZA WAY STE 117, MELBOURNE, FL, 329407306, US | |||||||||||||
|
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| Phone | +1 321-475-4265 |
Authorized person
| Name | BRENNA PEZO |
| Role | OWNER/LMHC |
| Phone | 3214754265 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| PEZO, BRENNA K | Agent | 681 BALLARD DRIVE, MELBOURNE, FL 32935 |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-01-22 |
Date of last update: 09 Feb 2025
Sources: Florida Department of State
