| Entity Name: | NEW LIFE CHRISTIAN COUNSELING CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 11 Apr 1994 (31 years ago) |
| Date of dissolution: | 29 Mar 2016 (9 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 29 Mar 2016 (9 years ago) |
| Document Number: | P94000027607 |
| FEI/EIN Number | 593240347 |
| Address: | 405 WAYMONT CT, STE 111, LAKE MARY, FL, 32746, US |
| Mail Address: | 405 WAYMONT CT, STE 111, LAKE MARY, FL, 32746, US |
| ZIP code: | 32746 |
| County: | Seminole |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1467491829 | 2006-06-04 | 2010-10-27 | 405 WAYMONT CT, STE. 111, LAKE MARY, FL, 327463586, US | 405 WAYMONT CT, STE. 111, LAKE MARY, FL, 327463586, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 407-322-6868 |
| Fax | 4073226868 |
Authorized person
| Name | DR. BRIAN MATTHEW CAMPBELL |
| Role | PRESIDENT |
| Phone | 4073226868 |
Taxonomy
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| License Number | PY0004142 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | AETNA PIN BRIAN CAMPBELL |
| Number | 0005337111 |
| State | FL |
| Issuer | NPI BRIAN M CAMPBELL |
| Number | 1093863466 |
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | 73535 |
| State | FL |
| Issuer | MAGELLAN - BRIAN CAMPBELL |
| Number | 131134000 |
| State | FL |
| Issuer | VALUOPTIONS-BRIANCAMPBELL |
| Number | 053111 |
| State | FL |
| Issuer | TRICARECHAMPUS |
| Number | 197423440 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CAMPBELL BRIAN M | Agent | 405 WAYMONT CT, LAKE MARY, FL, 32746 |
| Name | Role | Address |
|---|---|---|
| CAMPBELL CLAIRE | Director | 405 WAYMONT CT, LAKE MARY, FL, 32746 |
| CAMPBELL BRIAN M. | Director | 405 WAYMONT CT, LAKE MARY, FL, 32746 |
| Name | Role | Address |
|---|---|---|
| CAMPBELL CLAIRE | Vice President | 405 WAYMONT CT, LAKE MARY, FL, 32746 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2016-03-29 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2008-01-26 | 405 WAYMONT CT, STE 111, LAKE MARY, FL 32746 | No data |
| CHANGE OF MAILING ADDRESS | 2008-01-26 | 405 WAYMONT CT, STE 111, LAKE MARY, FL 32746 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 1999-03-22 | 405 WAYMONT CT, STE 111, LAKE MARY, FL 32746 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2016-03-29 |
| ANNUAL REPORT | 2015-01-20 |
| ANNUAL REPORT | 2014-02-24 |
| ANNUAL REPORT | 2013-03-21 |
| ANNUAL REPORT | 2012-03-28 |
| ANNUAL REPORT | 2011-03-18 |
| ANNUAL REPORT | 2010-03-09 |
| ANNUAL REPORT | 2009-01-12 |
| ANNUAL REPORT | 2008-01-26 |
| ANNUAL REPORT | 2007-03-06 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
