| Entity Name: | MEDICAL PSYCHOLOGY CENTER, PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 03 Jan 2006 (19 years ago) |
| Last Event: | CANCEL ADM DISS/REV |
| Event Date Filed: | 22 Oct 2007 (17 years ago) |
| Document Number: | P06000000277 |
| FEI/EIN Number | 204024751 |
| Address: | 570 MEMORIAL CIRCLE, SUITE 150, ORMOND BEACH, FL, 32174, US |
| Mail Address: | 570 MEMORIAL CIRCLE, SUITE 150, ORMOND BEACH, FL, 32174, US |
| ZIP code: | 32174 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1881891174 | 2007-06-29 | 2009-01-16 | 570 MEMORIAL CIR, STE 150, ORMOND BEACH, FL, 321745002, US | 570 MEMORIAL CIR, STE 150, ORMOND BEACH, FL, 321745002, US | |||||||||||||||||||
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| Phone | +1 386-672-9250 |
| Fax | 3866729251 |
Authorized person
| Name | DR. KATHERINE MARIE BILLIOT |
| Role | PRESIDENT |
| Phone | 3866729250 |
Taxonomy
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| License Number | PY7252 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BILLIOT KATHERINE M | Agent | 570 MEMORIAL CIRCLE, ORMOND BEACH, FL, 32174 |
| Name | Role | Address |
|---|---|---|
| BILLIOT KATHERINE M | President | 570 MEMORIAL CIRCLE STE 150, ORMOND BEACH, FL, 32174 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2009-01-19 | 570 MEMORIAL CIRCLE, SUITE 150, ORMOND BEACH, FL 32174 | No data |
| CHANGE OF MAILING ADDRESS | 2009-01-19 | 570 MEMORIAL CIRCLE, SUITE 150, ORMOND BEACH, FL 32174 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2009-01-19 | 570 MEMORIAL CIRCLE, SUITE 150, ORMOND BEACH, FL 32174 | No data |
| CANCEL ADM DISS/REV | 2007-10-22 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2007-10-22 | BILLIOT, KATHERINE M | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2007-09-14 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-11 |
| ANNUAL REPORT | 2023-03-20 |
| ANNUAL REPORT | 2022-02-25 |
| ANNUAL REPORT | 2021-03-16 |
| ANNUAL REPORT | 2020-01-20 |
| ANNUAL REPORT | 2019-03-07 |
| ANNUAL REPORT | 2018-01-16 |
| ANNUAL REPORT | 2017-02-08 |
| ANNUAL REPORT | 2016-01-14 |
| ANNUAL REPORT | 2015-02-23 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 8635758602 | 2021-03-25 | 0491 | PPS | 570 Memorial Cir Ste 150, Ormond Beach, FL, 32174-5062 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 9747397702 | 2020-05-01 | 0491 | PPP | 570 Memorial Circle, Suite 150, Ormond Beach, FL, 32174-5062 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 02 Feb 2025
Sources: Florida Department of State
