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LOTUS MENTAL HEALTH GROUP, P.A. - Florida Company Profile

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Company Details

Entity Name: LOTUS MENTAL HEALTH GROUP, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 09 Mar 2018 (7 years ago)
Last Event: REINSTATEMENT
Event Date Filed: 06 Dec 2022 (3 years ago)
Document Number: P18000023711
FEI/EIN Number 82-4717157
Address: 4175 Amber Street, Boulder, CO, 80304, US
Mail Address: 1193 SE Port St Lucie Blvd, Port St Lucie, FL, 34952, US
Place of Formation: FLORIDA

Links between entities

Type:
Headquarter of
Company Number:
20238354402
State:
COLORADO

Key Officers & Management

Name Role Address
CARRERA KATRINA President 4175 AMBER STREET, BOULDER, CO, 80304
CARRERA JOHN Chief Financial Officer 4175 AMBER STREET, BOULDER, CO, 80304
MACIAS TIARE Agent 1193 SE Port St Lucie Blvd, Port St Lucie, FL, 34952

National Provider Identifier

NPI Number:
1982375739
Certification Date:
2021-09-22

Authorized Person:

Name:
DR. KATRINA CARRERA
Role:
LICENSED PSYCHOLOGIST
Phone:

Taxonomy:

Selected Taxonomy:
261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center)
Is Primary:
Yes

Contacts:

Events

Event Type Filed Date Value Description
REGISTERED AGENT ADDRESS CHANGED 2024-04-30 1193 SE Port St Lucie Blvd, #139, Port St Lucie, FL 34952 -
CHANGE OF PRINCIPAL ADDRESS 2024-04-30 4175 Amber Street, Boulder, CO 80304 -
CHANGE OF MAILING ADDRESS 2024-04-30 4175 Amber Street, Boulder, CO 80304 -
REGISTERED AGENT NAME CHANGED 2024-04-29 MACIAS, TIARE -
REINSTATEMENT 2022-12-06 - -
ADMIN DISSOLUTION FOR ANNUAL REPORT 2022-09-23 - -
AMENDMENT 2021-10-04 - -
AMENDMENT AND NAME CHANGE 2021-09-07 LOTUS MENTAL HEALTH GROUP, P.A. -

Documents

Name Date
AMENDED ANNUAL REPORT 2024-04-30
ANNUAL REPORT 2024-04-29
ANNUAL REPORT 2023-03-27
REINSTATEMENT 2022-12-06
Amendment 2021-10-04
Amendment and Name Change 2021-09-07
ANNUAL REPORT 2021-01-27
ANNUAL REPORT 2020-03-20
ANNUAL REPORT 2019-05-01
Domestic Profit 2018-03-09

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Date of last update: 01 Aug 2025

Sources: Florida Department of State