| Entity Name: | PATRICK BOURSIQUOT LCSW, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 21 Apr 2008 (17 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 05 Oct 2010 (14 years ago) |
| Document Number: | P08000040136 |
| FEI/EIN Number | 262198818 |
| Address: | 15200 jog road, Delray Beach, FL, 33446, US |
| Mail Address: | 5018 Starblaze Dr, WEST PALM BEACH, FL, 33463, US |
| ZIP code: | 33446 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1205131786 | 2011-01-14 | 2011-01-14 | 951 SANSBURYS WAY, SUITE 206, WEST PALM BEACH, FL, 334113619, US | 951 SANSBURYS WAY, SUITE 206, WEST PALM BEACH, FL, 334113619, US | |||||||||||||||||||
|
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| Phone | +1 561-337-3647 |
| Fax | 5613373648 |
Authorized person
| Name | MR. PATRICK BOURSIQUOT |
| Role | PRESIDENT |
| Phone | 5613373647 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| License Number | SW5848 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BOURSIQUOT PATRICK | Agent | 5018 Starblaze Dr, WEST PALM BEACH, FL, 33463 |
| Name | Role | Address |
|---|---|---|
| BOURSIQUOT PATRICK | President | 5018 Starblaze Dr, WEST PALM BEACH, FL, 33463 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-04-16 | 15200 jog road, 303, Delray Beach, FL 33446 | No data |
| CHANGE OF MAILING ADDRESS | 2018-04-07 | 15200 jog road, 303, Delray Beach, FL 33446 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-04-07 | 5018 Starblaze Dr, WEST PALM BEACH, FL 33463 | No data |
| REINSTATEMENT | 2010-10-05 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-02 |
| ANNUAL REPORT | 2023-03-21 |
| ANNUAL REPORT | 2022-03-04 |
| ANNUAL REPORT | 2021-04-16 |
| ANNUAL REPORT | 2020-06-15 |
| ANNUAL REPORT | 2019-04-14 |
| ANNUAL REPORT | 2018-04-07 |
| ANNUAL REPORT | 2017-04-14 |
| ANNUAL REPORT | 2016-04-11 |
| ANNUAL REPORT | 2015-04-23 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
