| Entity Name: | DENIELE L DEGRYSE LMHC PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 29 May 2007 (18 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 19 Jun 2007 (18 years ago) |
| Document Number: | P07000063221 |
| FEI/EIN Number | 260260194 |
| Address: | 1786 17TH AVE. N, LAKE WORTH, FL, 33460, US |
| Mail Address: | 1786 17TH AVE. N, LAKE WORTH, FL, 33460, US |
| ZIP code: | 33460 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1689125445 | 2016-10-17 | 2016-10-17 | 1495 FOREST HILL BLVD STE G, WEST PALM BEACH, FL, 334066073, US | 1495 FOREST HILL BLVD STE G, WEST PALM BEACH, FL, 334066073, US | |||||||||||||||||||||||||
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| Phone | +1 561-635-4143 |
| Fax | 5614333596 |
Authorized person
| Name | DENIELE DEGRYSE |
| Role | OWNER |
| Phone | 5616354143 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| License Number | MH9065 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NPI |
| Number | 1023276094 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| DEGRYSE DENIELE L | Agent | 1786 17th Ave. N, Lake worth, FL, 33460 |
| Name | Role | Address |
|---|---|---|
| DEGRYSE DENIELE L | President | 1786 17th Ave. N, Lake worth, FL, 33460 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2018-04-08 | 1786 17th Ave. N, Lake worth, FL 33460 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-03-22 | 1786 17TH AVE. N, LAKE WORTH, FL 33460 | No data |
| CHANGE OF MAILING ADDRESS | 2018-03-22 | 1786 17TH AVE. N, LAKE WORTH, FL 33460 | No data |
| AMENDMENT | 2007-06-19 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-02 |
| ANNUAL REPORT | 2023-03-15 |
| ANNUAL REPORT | 2022-02-11 |
| ANNUAL REPORT | 2021-02-07 |
| ANNUAL REPORT | 2020-03-07 |
| ANNUAL REPORT | 2019-05-19 |
| ANNUAL REPORT | 2018-04-08 |
| ANNUAL REPORT | 2017-03-18 |
| ANNUAL REPORT | 2016-03-22 |
| ANNUAL REPORT | 2015-03-07 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
