| Entity Name: | COLLABORATIVE SOLUTIONS BY DR NIKKI KEEFER & ASSOCIATES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 28 Mar 2006 (19 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 07 Nov 2018 (6 years ago) |
| Document Number: | P06000044675 |
| FEI/EIN Number | 204582177 |
| Address: | 3516 Wild Eagle Run, Oviedo, FL, 32766, US |
| Mail Address: | 3516 Wild Eagle Run, Oviedo, FL, 32766, US |
| ZIP code: | 32766 |
| County: | Seminole |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1619111630 | 2009-04-21 | 2013-12-02 | 4541 ALRIX DR, ORLANDO, FL, 328393160, US | 4541 ALRIX DR, ORLANDO, FL, 328393160, US | |||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 407-489-2121 |
| Fax | 4073522026 |
Authorized person
| Name | DR. NIKKI LYN KEEFER |
| Role | OWNER |
| Phone | 4074892121 |
Taxonomy
| Taxonomy Code | 101Y00000X - Counselor |
| License Number | MH10896 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | No |
| Taxonomy Code | 101YP2500X - Professional Counselor |
| Is Primary | No |
| Taxonomy Code | 103K00000X - Behavior Analyst |
| Is Primary | No |
| Taxonomy Code | 106H00000X - Marriage & Family Therapist |
| Is Primary | No |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDWAIVER DD |
| Number | 685758296 |
| State | FL |
| Issuer | MEDWAIVER HCBS |
| Number | 685758298 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| KEEFER NIKKI L | Agent | 3516 Wild Eagle Run, Oviedo, FL, 32766 |
| Name | Role | Address |
|---|---|---|
| KEEFER NIKKI L | President | 3516 Wild Eagle Run, Oviedo, FL, 32766 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000116086 | COLLABORATIVE SOLUTIONS ACADEMY | ACTIVE | 2021-09-09 | 2026-12-31 | No data | 3516 WILD EAGLE RUN, OVIEDO, FL, 32766 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2018-11-07 | KEEFER, NIKKI L | No data |
| REINSTATEMENT | 2018-11-07 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2015-04-22 | 3516 Wild Eagle Run, Oviedo, FL 32766 | No data |
| CHANGE OF MAILING ADDRESS | 2015-04-22 | 3516 Wild Eagle Run, Oviedo, FL 32766 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2015-04-22 | 3516 Wild Eagle Run, Oviedo, FL 32766 | No data |
| AMENDMENT | 2010-02-08 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-12 |
| ANNUAL REPORT | 2023-04-26 |
| ANNUAL REPORT | 2022-03-28 |
| ANNUAL REPORT | 2021-04-15 |
| ANNUAL REPORT | 2020-06-10 |
| ANNUAL REPORT | 2019-07-13 |
| REINSTATEMENT | 2018-11-07 |
| ANNUAL REPORT | 2017-06-30 |
| ANNUAL REPORT | 2016-03-29 |
| ANNUAL REPORT | 2015-04-22 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
