| Entity Name: | CHRYSALIS COUNSELING FLORIDA LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 07 Mar 2024 (a year ago) |
| Document Number: | L24000117062 |
| Address: | 2028 BRENDLA RD, CLEARWATER, FL 33755 |
| Mail Address: | 2028 BRENDLA RD, CLEARWATER, FL 33755-1309 UN |
| ZIP code: | 33755 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1679332563 | 2024-03-14 | 2024-03-14 | 2028 BRENDLA RD, CLEARWATER, FL, 337551309, US | 2028 BRENDLA RD, CLEARWATER, FL, 337551309, US | |||||||||||||||||
|
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| Phone | +1 314-780-8328 |
Authorized person
| Name | CLAUDINE MILLER |
| Role | OWNER |
| Phone | 3147808328 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | Yes |
| Taxonomy Code | 101YP2500X - Professional Counselor |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| MILLER, CLAUDINE, LMHC | Agent | 2028 BRENDLA RD, CLEARWATER, FL 33755 |
| Name | Role | Address |
|---|---|---|
| MILLER, CLAUDINE, LMHC | Authorized Person | 2028 BRENDLA RD, CLEARWATER, FL 33755 |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-03-07 |
Date of last update: 08 Feb 2025
Sources: Florida Department of State
