| Entity Name: | PEGGY BAILEY LMHC, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 16 Mar 2004 (21 years ago) |
| Date of dissolution: | 26 Sep 2014 (10 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 26 Sep 2014 (10 years ago) |
| Document Number: | P04000049819 |
| FEI/EIN Number | 200857345 |
| Address: | 774 STATE RD 13 N, SUITE 7, ST JOHNS, FL, 32259 |
| Mail Address: | 774 STATE RD 13 N, SUITE 7, ST JOHNS, FL, 32259 |
| ZIP code: | 32259 |
| County: | St. Johns |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1194099077 | 2012-02-24 | 2012-02-24 | 774 STATE ROAD 13, STE 7, SAINT JOHNS, FL, 322593857, US | 774 STATE ROAD 13, STE 7, SAINT JOHNS, FL, 322593857, US | |||||||||||||||||||||||||
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| Phone | +1 904-287-0820 |
| Fax | 9042874141 |
Authorized person
| Name | MRS. MARGARET E BAILEY |
| Role | OWNER |
| Phone | 9042870820 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| License Number | MH 3293 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 688076296 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BAILEY MARGARET E | Agent | 774 STATE RD 13 N, ST JOHNS, FL, 32259 |
| Name | Role | Address |
|---|---|---|
| BAILEY MARGARET E | President | 774 STATE RD 13 N, STE 7, ST JOHNS, FL, 32259 |
| Name | Role | Address |
|---|---|---|
| BAILEY MARGARET E | Vice President | 774 STATE RD 13 N, STE 7, ST JOHNS, FL, 32259 |
| Name | Role | Address |
|---|---|---|
| BAILEY MARGARET E | Secretary | 774 STATE RD 13 N, STE 7, ST JOHNS, FL, 32259 |
| Name | Role | Address |
|---|---|---|
| BAILEY MARGARET E | Treasurer | 774 STATE RD 13 N, STE 7, ST JOHNS, FL, 32259 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-04-13 | 774 STATE RD 13 N, SUITE 7, ST JOHNS, FL 32259 | No data |
| CHANGE OF MAILING ADDRESS | 2012-04-13 | 774 STATE RD 13 N, SUITE 7, ST JOHNS, FL 32259 | No data |
| REGISTERED AGENT NAME CHANGED | 2012-04-13 | BAILEY, MARGARET E | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2012-04-13 | 774 STATE RD 13 N, SUITE 7, ST JOHNS, FL 32259 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2013-04-29 |
| ANNUAL REPORT | 2012-04-13 |
| ANNUAL REPORT | 2011-04-19 |
| ANNUAL REPORT | 2010-04-24 |
| ANNUAL REPORT | 2009-04-14 |
| ANNUAL REPORT | 2008-04-28 |
| ANNUAL REPORT | 2007-03-28 |
| ANNUAL REPORT | 2006-07-12 |
| ANNUAL REPORT | 2005-04-07 |
| Domestic Profit | 2004-03-16 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
