| Entity Name: | SUSAN N. YOUNG, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 31 Aug 2006 (18 years ago) |
| Document Number: | P06000113168 |
| FEI/EIN Number | 205468754 |
| Address: | 14286 BEACH BLVD.,, SUITE 22, JACKSONVILLE, FL, 32250, US |
| Mail Address: | 14286 BEACH BLVD.,, SUITE 22, JACKSONVILLE, FL, 32250, US |
| ZIP code: | 32250 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1770788390 | 2007-06-15 | 2011-10-17 | 13400 SUTTON PARK DR S, SUITE 1504, JACKSONVILLE, FL, 322240236, US | 13400 SUTTON PARK DR S, SUITE 1504, JACKSONVILLE, FL, 322240236, US | |||||||||||||||||||||||||
|
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| Phone | +1 904-223-6414 |
| Fax | 9042236418 |
Authorized person
| Name | DR. SUSAN N YOUNG |
| Role | OWNER |
| Phone | 9042236414 |
Taxonomy
| Taxonomy Code | 103G00000X - Clinical Neuropsychologist |
| License Number | PY7306 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE PTAN |
| Number | AF756 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| YOUNG SUSAN N | Agent | 366 Charlie Way, St. Augustine, FL, 32095 |
| Name | Role | Address |
|---|---|---|
| Young Susan N | Manager | 366 Charlie Way, St. Augustine, FL, 32095 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G13000032296 | SUITE 22 PSYCHOLOGICAL SERVICES | EXPIRED | 2013-04-03 | 2018-12-31 | No data | 600 IRONWOOD DR., UNIT 635, PONTE VEDRA BEACH, FL, 32082 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2022-02-01 | 366 Charlie Way, St. Augustine, FL 32095 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2013-08-20 | 14286 BEACH BLVD.,, SUITE 22, JACKSONVILLE, FL 32250 | No data |
| CHANGE OF MAILING ADDRESS | 2013-08-20 | 14286 BEACH BLVD.,, SUITE 22, JACKSONVILLE, FL 32250 | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J23000151332 | ACTIVE | 1000000947994 | DUVAL | 2023-04-05 | 2033-04-12 | $ 630.15 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, JACKSONVILLE SERVICE CENTER, 921 N DAVIS ST STE 250A, JACKSONVILLE FL322096825 |
| J21000644447 | TERMINATED | 1000000910514 | DUVAL | 2021-12-10 | 2031-12-15 | $ 522.23 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, JACKSONVILLE SERVICE CENTER, 921 N DAVIS ST STE 250A, JACKSONVILLE FL322096825 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-09 |
| ANNUAL REPORT | 2023-02-01 |
| ANNUAL REPORT | 2022-02-01 |
| ANNUAL REPORT | 2021-03-04 |
| ANNUAL REPORT | 2020-03-04 |
| ANNUAL REPORT | 2019-04-10 |
| ANNUAL REPORT | 2018-03-01 |
| ANNUAL REPORT | 2017-03-31 |
| ANNUAL REPORT | 2016-03-28 |
| ANNUAL REPORT | 2015-03-22 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
