| Entity Name: | PSYCHOLOGY GROUP OF TAMPA BAY,INC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
PSYCHOLOGY GROUP OF TAMPA BAY,INC is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 13 Feb 2020 (5 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 26 Sep 2023 (2 years ago) |
| Document Number: | P20000015155 |
| FEI/EIN Number |
84-4717759
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 1207 E GIDDENS AVE, TAMPA, FL, 33603, US |
| Mail Address: | 1207 E GIDDENS AVE, TAMPA, FL, 33603, US |
| ZIP code: | 33603 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1801421524 | 2020-03-04 | 2024-01-23 | 6515 N ARMENIA AVE, TAMPA, FL, 336045713, US | 6515 N ARMENIA AVE, TAMPA, FL, 336045713, US | |||||||||||||||||||||
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| Phone | +1 813-575-4238 |
| Phone | +1 813-359-1995 |
Authorized person
| Name | DR. MICHAEL WUSIK |
| Role | CEO |
| Phone | 8135754238 |
Taxonomy
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1922459460 |
| State | MD |
| Name | Role | Address |
|---|---|---|
| WUSIK MICHAEL F | Chief Executive Officer | 1207 E GIDDENS AVE, TAMPA, FL, 33603 |
| GINNS DIANA PHD | Chief Operating Officer | 1207 E GIDDENS AVE, TAMPA, FL, 33603 |
| WUSIK MICHAEL FPHD | Agent | 1207 E GIDDENS AVE, TAMPA, FL, 33603 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000085317 | DYNAMIC STATE BEHAVIORAL HEALTH | ACTIVE | 2022-07-19 | 2027-12-31 | - | 1207 E GIDDENS AVE, TAMPA, FL, 33603 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2023-09-26 | - | - |
| REGISTERED AGENT NAME CHANGED | 2023-09-26 | WUSIK, MICHAEL F, PHD | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | - | - |
| AMENDMENT AND NAME CHANGE | 2022-05-10 | PSYCHOLOGY GROUP OF TAMPA BAY,INC | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-02-07 |
| ANNUAL REPORT | 2024-01-03 |
| REINSTATEMENT | 2023-09-26 |
| Amendment and Name Change | 2022-05-10 |
| ANNUAL REPORT | 2022-01-06 |
| ANNUAL REPORT | 2021-02-02 |
| Domestic Profit | 2020-02-13 |
Date of last update: 02 Apr 2025
Sources: Florida Department of State
