| Entity Name: | SMITH MENTAL HEALTH ASSOCIATES, L.L.C. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 24 Jun 1999 (26 years ago) |
| Document Number: | L99000003706 |
| FEI/EIN Number | 650929557 |
| Address: | 601 SOUTH STATE RD 7, PLANTATION, FL, 33317 |
| Mail Address: | 601 SOUTH STATE RD 7, PLANTATION, FL, 33317 |
| ZIP code: | 33317 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1710439690 | 2016-10-26 | 2017-10-27 | 601 S STATE ROAD 7, PLANTATION, FL, 333174054, US | 601 S STATE ROAD 7, PLANTATION, FL, 333174054, US | |||||||||||||||||||||
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| Phone | +1 954-321-2296 |
| Fax | 9543215399 |
Authorized person
| Name | JOANNE CORREIA-KENT |
| Role | AGENCY CO-ADMINISTRATOR |
| Phone | 9543212296 |
Taxonomy
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 070164500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| WILSON SEAN L | Agent | 1880 N. Congress Avenue, Boynton Beach, FL, 33426 |
| Name | Role | Address |
|---|---|---|
| JOANNE CORREIA-KENT | Managing Member | 6007 NW 65 TERRACE, PARKLAND, FL, 33067 |
| Donna Lavalle | Managing Member | 2819 NE 21st Terrace, Fort Lauderdale, FL, 33306 |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
