| Entity Name: | DEBORAH L. MCCOY BEHAVIOR ANALYST, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 12 May 2003 (22 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 30 Sep 2022 (2 years ago) |
| Document Number: | P03000051935 |
| FEI/EIN Number | 80-0069713 |
| Address: | 3261 US Hwy 27/441, Bldg C2, Fruitland Park, FL 34731 |
| Mail Address: | 3261 US Hwy 27/441, Bldg C2, Fruitland Park, FL 34731 |
| ZIP code: | 34731 |
| County: | Lake |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1952628059 | 2010-04-28 | 2022-09-30 | 2860 W MAIN ST, LEESBURG, FL, 347484631, US | 2860 W MAIN ST, LEESBURG, FL, 347484631, US | |||||||||||||||||||||||||||||||||||||||
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| Phone | +1 813-957-8327 |
| Fax | 8664710650 |
Authorized person
| Name | MS. DEBORAH L MCCOY |
| Role | PRESIDENT/CEO |
| Phone | 8139578327 |
Taxonomy
| Taxonomy Code | 103K00000X - Behavior Analyst |
| License Number | 1-01-0560 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 103K00000X - Behavior Analyst |
| License Number | 0-08-2523 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 01851200 |
| State | FL |
| Issuer | MEDICAID WAIVER |
| Number | 676938196 |
| State | FL |
| Name | Role |
|---|---|
| WHWW, INC. | Agent |
| Name | Role | Address |
|---|---|---|
| MCCOY, DEBORAH L | President | 3261 US Hwy 27/441, Bldg C2, Fruitland Park, FL 34731 |
| Name | Role | Address |
|---|---|---|
| MCCOY, DEBORAH L | Secretary | 3261 US Hwy 27/441, Bldg C2, Fruitland Park, FL 34731 |
| Name | Role | Address |
|---|---|---|
| MCCOY, DEBORAH L | Treasurer | 3261 US Hwy 27/441, Bldg C2, Fruitland Park, FL 34731 |
| Name | Role | Address |
|---|---|---|
| MCCOY, DEBORAH L | Director | 3261 US Hwy 27/441, Bldg C2, Fruitland Park, FL 34731 |
| Name | Role | Address |
|---|---|---|
| MCCOY, AMANDA | Vice President | 3261 US Hwy 27/441, Bldg C2, Fruitland Park, FL 34731 |
| MCCOY, SEAN | Vice President | 3261 US Hwy 27/441, Bldg C2, Fruitland Park, FL 34731 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G18000028252 | MCCOY BEHAVIORAL | ACTIVE | 2018-02-27 | 2028-12-31 | No data | 2860 W MAIN ST, LEESBURG, FL, 34748 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-11-15 | 3261 US Hwy 27/441, Bldg C2, Fruitland Park, FL 34731 | No data |
| CHANGE OF MAILING ADDRESS | 2024-11-15 | 3261 US Hwy 27/441, Bldg C2, Fruitland Park, FL 34731 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-09-30 | 329 PARK AVE NORTH, SECOND FLOOR, WINTER PARK, FL 32789 | No data |
| REINSTATEMENT | 2022-09-30 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2022-09-30 | WHWW, INC. | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| AMENDMENT | 2019-05-07 | No data | No data |
| AMENDMENT | 2005-03-14 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-29 |
| ANNUAL REPORT | 2023-03-09 |
| REINSTATEMENT | 2022-09-30 |
| ANNUAL REPORT | 2021-04-30 |
| ANNUAL REPORT | 2020-03-06 |
| Amendment | 2019-05-07 |
| ANNUAL REPORT | 2019-04-25 |
| ANNUAL REPORT | 2018-03-05 |
| ANNUAL REPORT | 2017-04-26 |
| ANNUAL REPORT | 2016-04-12 |
Date of last update: 06 Jan 2025
Sources: Florida Department of State
