| Entity Name: | BAY AREA PSYCHOLOGICAL CARE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 14 Jul 2000 (25 years ago) |
| Date of dissolution: | 04 Oct 2002 (22 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 04 Oct 2002 (22 years ago) |
| Document Number: | P00000067386 |
| FEI/EIN Number | 593661823 |
| Mail Address: | 3000 GULF TO BAY BLVD., CLEARWATER, FL, 33759 |
| Address: | 3000 GULF TO BAY BLVD., 219, CLEARWATER, FL, 33759 |
| ZIP code: | 33759 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1669585444 | 2006-08-16 | 2020-08-22 | PO BOX 242, OLDSMAR, FL, 346770242, US | 3780 TAMPA RD, SUITE 115, OLDSMAR, FL, 346773041, US | |||||||||||||||||||||||||||||||||||||||
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| Phone | +1 727-771-6339 |
| Fax | 7277716338 |
Authorized person
| Name | DR. LISA MARI PETRICA |
| Role | OWNER/LICENSED PSYCHOLOGIST |
| Phone | 7277716339 |
Taxonomy
| Taxonomy Code | 103T00000X - Psychologist |
| License Number | PY5976 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| License Number | PY5976 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | BLUE CROSS/BLUE SHIELD |
| Number | 54612 |
| State | FL |
| Issuer | MEDICAID |
| Number | 179953 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PETRICA LISA M | Agent | 3000 GULF TO BAY BLVD, CLEARWATER, FL, 33759 |
| Name | Role | Address |
|---|---|---|
| PETRICA LISA M | President | 3000 GULF TO BAY BLVD., CLEARWATER, FL, 33759 |
| Name | Role | Address |
|---|---|---|
| PETRICA LISA M | Secretary | 3000 GULF TO BAY BLVD., CLEARWATER, FL, 33759 |
| Name | Role | Address |
|---|---|---|
| PETRICA LISA M | Treasurer | 3000 GULF TO BAY BLVD., CLEARWATER, FL, 33759 |
| Name | Role | Address |
|---|---|---|
| PETRICA LISA M | Director | 3000 GULF TO BAY BLVD., CLEARWATER, FL, 33759 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2002-10-04 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2001-04-04 | 3000 GULF TO BAY BLVD., 219, CLEARWATER, FL 33759 | No data |
| REGISTERED AGENT NAME CHANGED | 2001-04-04 | PETRICA, LISA M | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2001-04-04 | 3000 GULF TO BAY BLVD, SUITE 219, CLEARWATER, FL 33759 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2001-04-04 |
| Domestic Profit | 2000-07-14 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
