| Entity Name: | AWARENESS COUNSELING CENTER OF THE INDIAN RIVER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 31 Jul 2000 (24 years ago) |
| Document Number: | P00000073620 |
| FEI/EIN Number | 651054008 |
| Address: | 805 Sebastian Blvd, Suite 2, SEBASTIAN, FL, 32958, US |
| Mail Address: | 13537 US HIGHWAY 1, PMB 137, SEBASTIAN, FL, 32958, US |
| ZIP code: | 32958 |
| County: | Indian River |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1265631790 | 2007-07-14 | 2008-02-14 | 13537 US HIGHWAY 1, #137, SEBASTIAN, FL, 329583760, US | 7766 BAY ST, #11, SEBASTIAN, FL, 329583427, US | |||||||||||||||||||||||||
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| Phone | +1 772-589-7008 |
| Fax | 7725897008 |
Authorized person
| Name | MS. GANGA MAYEE JOYCE WASSERMAN |
| Role | PRESIDENT/OWNER |
| Phone | 7725897008 |
Taxonomy
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| License Number | SW6348 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PROVIDER NUMBER |
| Number | Z9500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MCKINNON, CHARLES W. | Agent | 3055 Cardinal Dr, VERO BEACH, FL, 32963 |
| Name | Role | Address |
|---|---|---|
| WASSERMAN GANGA MAYEE JLCSW | Director | PMB 137, SEBASTIAN, FL, 32958 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2007-08-20 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2006-09-15 | No data | No data |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
