| Entity Name: | CREATIVE COMMUNITY COUNSELING, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 09 Sep 2014 (10 years ago) |
| Document Number: | P14000074690 |
| FEI/EIN Number | 475258130 |
| Address: | 202 LAKE MIRIAM DRIVE, LAKELAND, FL, 32813, US |
| Mail Address: | 202 LAKE MIRIAM DRIVE, LAKELAND, FL, 32813, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043694219 | 2015-07-16 | 2024-10-21 | 202 LAKE MIRIAM DR, LAKELAND, FL, 338132180, US | 202 LAKE MIRIAM DR, W6, LAKELAND, FL, 338132180, US | |||||||||||||||||||||||||
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| Phone | +1 863-226-5081 |
Authorized person
| Name | CATHY GHENT |
| Role | CLINICAL DIRECTOR |
| Phone | 8632265081 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | Yes |
| Taxonomy Code | 251B00000X - Case Management Agency |
| Is Primary | No |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | No |
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| GHENT CATHY | Agent | 202 Lake Miriam Dr., LAKELAND, FL, 33813 |
| Name | Role | Address |
|---|---|---|
| Ghent Cathy | Chief Executive Officer | 202 Lake Miriam Dr, Lakeland, FL, 33813 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2017-04-28 | 202 Lake Miriam Dr., W6, LAKELAND, FL 33813 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2015-11-10 | 202 LAKE MIRIAM DRIVE, SUITE W6, LAKELAND, FL 32813 | No data |
| CHANGE OF MAILING ADDRESS | 2015-11-10 | 202 LAKE MIRIAM DRIVE, SUITE W6, LAKELAND, FL 32813 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-29 |
| ANNUAL REPORT | 2023-04-28 |
| ANNUAL REPORT | 2022-04-28 |
| ANNUAL REPORT | 2021-04-22 |
| ANNUAL REPORT | 2020-04-30 |
| ANNUAL REPORT | 2019-04-03 |
| ANNUAL REPORT | 2018-04-26 |
| ANNUAL REPORT | 2017-04-28 |
| ANNUAL REPORT | 2016-04-15 |
| ANNUAL REPORT | 2015-09-21 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
