| Entity Name: | NORTHWEST FLORIDA PSYCHOLOGICAL SERVICES, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 18 May 2010 (15 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 23 Oct 2019 (5 years ago) |
| Document Number: | P10000042843 |
| FEI/EIN Number | 27-2604024 |
| Address: | 1992 LEWIS TURNER BLVD, FORT WALTON BEACH, FL 32547 |
| Mail Address: | PO BOX 1021, MARY ESTHER, FL 32569 |
| ZIP code: | 32547 |
| County: | Okaloosa |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1881908689 | 2010-08-04 | 2015-10-23 | 519 BOULDER ST, CRESTVIEW, FL, 325362251, US | 151 MARY ESTHER BLVD, STE 308A, MARY ESTHER, FL, 325691972, US | |||||||||||||||||||
|
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| Phone | +1 850-226-7322 |
| Fax | 8502267491 |
Authorized person
| Name | DR. JULIE HARPER |
| Role | LICENSED PSYCHOLOGIST |
| Phone | 8502267322 |
Taxonomy
| Taxonomy Code | 103T00000X - Psychologist |
| License Number | PY0007168 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| HARPER, RUDOLF W | Agent | 1992 LEWIS TURNER BLVD, FORT WALTON BEACH, FL 32547 |
| Name | Role | Address |
|---|---|---|
| HARPER, JULIE F | President | PO BOX 1021, MARY ESTHER, FL 32569 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2019-10-23 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2019-10-23 | HARPER, RUDOLF W | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-10-23 | 1992 LEWIS TURNER BLVD, FORT WALTON BEACH, FL 32547 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2017-09-13 | 1992 LEWIS TURNER BLVD, FORT WALTON BEACH, FL 32547 | No data |
| CHANGE OF MAILING ADDRESS | 2017-09-13 | 1992 LEWIS TURNER BLVD, FORT WALTON BEACH, FL 32547 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-06 |
| ANNUAL REPORT | 2023-03-05 |
| ANNUAL REPORT | 2022-04-06 |
| ANNUAL REPORT | 2021-03-18 |
| ANNUAL REPORT | 2020-03-25 |
| REINSTATEMENT | 2019-10-23 |
| ANNUAL REPORT | 2018-07-02 |
| ANNUAL REPORT | 2017-05-02 |
| ANNUAL REPORT | 2016-04-15 |
| ANNUAL REPORT | 2015-02-23 |
Date of last update: 25 Jan 2025
Sources: Florida Department of State
