| Entity Name: | REBECCA ELLINGER, PSY, D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 17 Jan 2018 (7 years ago) |
| Document Number: | P18000005104 |
| FEI/EIN Number | 824149050 |
| Address: | 12116 LAVITA WAY, BOYNTON BEACH, FL, 33437, US |
| Mail Address: | 1067 CIRCLE DRIVE, APT A, DELRAY BEACH, FL, 33445, US |
| ZIP code: | 33437 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1265934111 | 2018-03-07 | 2023-12-07 | 1067 CIRCLE DR APT A, DELRAY BEACH, FL, 334453044, US | 1067 CIRCLE DR APT A, DELRAY BEACH, FL, 334453044, US | |||||||||||||||||||
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| Phone | +1 561-498-5300 |
| Fax | 5614985301 |
Authorized person
| Name | DR. REBECCA S ELLINGER |
| Role | CLINICAL PSYCHOLOGIST |
| Phone | 5614985300 |
Taxonomy
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| License Number | PY4112 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Ellinger Rebecca Dr. | Agent | 16244 S. Military Trail, Delray Beach, FL, 33484 |
| Name | Role | Address |
|---|---|---|
| ELLINGER REBECCA | Director | 16244 SOUTH MILITARY TRAIL SUITE 460, DELRAY BEACH, FL, 33484 |
| ELLINGER REBECCA Dr. | Director | 12116 LAVITA WAY, BOYNTON BEACH, FL, 33437 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-04 | 12116 LAVITA WAY, BOYNTON BEACH, FL 33437 | No data |
| CHANGE OF MAILING ADDRESS | 2024-04-04 | 12116 LAVITA WAY, BOYNTON BEACH, FL 33437 | No data |
| REGISTERED AGENT NAME CHANGED | 2019-01-02 | Ellinger, Rebecca, Dr. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-01-02 | 16244 S. Military Trail, #460, Delray Beach, FL 33484 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-04 |
| ANNUAL REPORT | 2023-04-11 |
| ANNUAL REPORT | 2022-02-15 |
| ANNUAL REPORT | 2021-03-15 |
| ANNUAL REPORT | 2020-06-10 |
| ANNUAL REPORT | 2019-01-02 |
| Domestic Profit | 2018-01-17 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
