| Entity Name: | MARCUS PSYCHOLOGY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 21 Jun 2006 (19 years ago) |
| Document Number: | P06000084876 |
| FEI/EIN Number | 223936604 |
| Address: | 7685 SOUTHWEST 104TH STREET, SUITE 100, MIAMI, FL, 33156 |
| Mail Address: | 7685 SOUTHWEST 104TH STREET, SUITE 100, MIAMI, FL, 33156 |
| ZIP code: | 33156 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1669517462 | 2007-02-20 | 2020-08-22 | 7685 SW 104TH ST, SUITE 100, MIAMI, FL, 331563161, US | 7685 SW 104TH ST, SUITE 100, MIAMI, FL, 331563161, US | |||||||||||||||||||||||||
|
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| Phone | +1 305-666-8000 |
| Fax | 3056664311 |
Authorized person
| Name | DR. NICOLE ELDRIDGE MARCUS |
| Role | DIRECTOR, LICENSED PSYCHOLOGIST |
| Phone | 3056668000 |
Taxonomy
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| License Number | PY7161 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | 75024 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MARCUS JEFFREY E | Agent | 7685 SOUTHWEST 104TH STREET STE 100, MIAMI, FL, 33156 |
| Name | Role | Address |
|---|---|---|
| MARCUS NICOLE | President | 7685 SOUTHWEST 104TH STREET, SUITE 100, MIAMI, FL, 33156 |
| Name | Role | Address |
|---|---|---|
| MARCUS NICOLE | Secretary | 7685 SOUTHWEST 104TH STREET, SUITE 100, MIAMI, FL, 33156 |
| Name | Role | Address |
|---|---|---|
| MARCUS NICOLE | Treasurer | 7685 SOUTHWEST 104TH STREET, SUITE 100, MIAMI, FL, 33156 |
| Name | Role | Address |
|---|---|---|
| MARCUS NICOLE | Director | 7685 SOUTHWEST 104TH STREET, SUITE 100, MIAMI, FL, 33156 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2009-04-15 | 7685 SOUTHWEST 104TH STREET STE 100, 100, MIAMI, FL 33156 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2007-07-11 | 7685 SOUTHWEST 104TH STREET, SUITE 100, MIAMI, FL 33156 | No data |
| REGISTERED AGENT NAME CHANGED | 2007-07-11 | MARCUS, JEFFREY E | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-05 |
| ANNUAL REPORT | 2023-07-12 |
| ANNUAL REPORT | 2022-03-04 |
| ANNUAL REPORT | 2021-04-08 |
| ANNUAL REPORT | 2020-06-29 |
| ANNUAL REPORT | 2019-04-26 |
| ANNUAL REPORT | 2018-04-24 |
| ANNUAL REPORT | 2017-04-29 |
| ANNUAL REPORT | 2016-04-24 |
| ANNUAL REPORT | 2015-04-23 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
