| Entity Name: | JENNIFER TICKAL, PSY.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 05 Feb 2016 (9 years ago) |
| Document Number: | P16000012197 |
| FEI/EIN Number | 81-1447352 |
| Address: | 1809 East Broadway Street, # 133, Oviedo, FL 32765 |
| Mail Address: | 1809 East Broadway Street, # 133, Oviedo, FL 32765 |
| ZIP code: | 32765 |
| County: | Seminole |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1023477221 | 2016-02-16 | 2021-01-18 | 2328 FOLIAGE OAK TER, OVIEDO, FL, 327667021, US | 1555 N MAITLAND AVE, MAITLAND, FL, 327513325, US | |||||||||||||||||||
|
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| Phone | +1 321-217-6086 |
| Phone | +1 813-563-5676 |
Authorized person
| Name | DR. JENNIFER TICKAL |
| Role | CLINICAL PSYCHOLOGIST |
| Phone | 3212176086 |
Taxonomy
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| License Number | PY8723 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| TICKAL, JENNIFER | Agent | 1809 East Broadway Street, # 133, Oviedo, FL 32765 |
| Name | Role | Address |
|---|---|---|
| TICKAL, JENNIFER | President | 1809 East Broadway Street, # 133 Oviedo, FL 32765 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G18000064646 | RESTORE AND RENEW COUNSELING AND CONSULTING | ACTIVE | 2018-06-02 | 2028-12-31 | No data | 1809 EAST BROADWAY STREET, # 133, OVIEDO, FL, 32765 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-09-26 | 1809 East Broadway Street, # 133, Oviedo, FL 32765 | No data |
| CHANGE OF MAILING ADDRESS | 2022-09-26 | 1809 East Broadway Street, # 133, Oviedo, FL 32765 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-09-26 | 1809 East Broadway Street, # 133, Oviedo, FL 32765 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-14 |
| ANNUAL REPORT | 2024-01-16 |
| ANNUAL REPORT | 2023-01-26 |
| AMENDED ANNUAL REPORT | 2022-09-26 |
| ANNUAL REPORT | 2022-01-19 |
| ANNUAL REPORT | 2021-01-21 |
| ANNUAL REPORT | 2020-01-23 |
| ANNUAL REPORT | 2019-01-16 |
| ANNUAL REPORT | 2018-01-13 |
| ANNUAL REPORT | 2017-01-10 |
Date of last update: 19 Feb 2025
Sources: Florida Department of State
