| Entity Name: | PATRICIA LEWIS-SLAYTON LCSW, LMFT, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 21 Jan 2009 (16 years ago) |
| Date of dissolution: | 28 Sep 2012 (12 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2012 (12 years ago) |
| Document Number: | P09000006552 |
| FEI/EIN Number | 270406461 |
| Address: | 2112 W LYMINGTON WAY, ST AUGUSTINE, FL, 32084 |
| Mail Address: | 2112 W LYMINGTON WAY, ST AUGUSTINE, FL, 32084 |
| ZIP code: | 32084 |
| County: | St. Johns |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1215260609 | 2009-09-16 | 2009-09-16 | 2112 W. LYMINGTON WAY, ST. AUGUSTINE, FL, 32084, US | 1100 S PONCE DE LEON BLVD STE 1, ST AUGUSTINE, FL, 320846013, US | |||||||||||||||||||
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| Phone | +1 904-824-7733 |
| Fax | 9048299768 |
Authorized person
| Name | MS. PATRICIA LEWIS-SLAYTON |
| Role | PSYCHOTHERAPIST |
| Phone | 9048227733 |
Taxonomy
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| License Number | SW1594 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| LEWIS-SLAYTON PATRICIA L | Agent | 2112 W LYMINGTON WAY, ST AUGUSTINE, FL, 32084 |
| Name | Role | Address |
|---|---|---|
| LEWIS-SLAYTON PATRICIA | President | 2112 W. LYMINGTON WAY, ST. AUGUSTINE, FL, 32084 |
| Name | Role | Address |
|---|---|---|
| LEWIS-SLAYTON PATRICIA | Director | 2112 W. LYMINGTON WAY, ST. AUGUSTINE, FL, 32084 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2012-09-28 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2011-01-19 |
| ANNUAL REPORT | 2010-01-11 |
| Domestic Profit | 2009-01-21 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
