| Entity Name: | CLINICAL PSYCHOLOGY ASSOCIATES, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 12 Sep 1994 (30 years ago) |
| Date of dissolution: | 23 Sep 2016 (8 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2016 (8 years ago) |
| Document Number: | P94000067802 |
| FEI/EIN Number | 59-3266033 |
| Address: | 4400 BAYOU BLVD.,, BLDG # 51, PENSACOLA, FL 32503 |
| Mail Address: | 4400 BAYOU BLVD.,, BLDG # 51, PENSACOLA, FL 32503 |
| ZIP code: | 32503 |
| County: | Escambia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1659418945 | 2007-01-30 | 2020-08-22 | 4400 BAYOU BLVD, SUITE 51, PENSACOLA, FL, 325032673, US | 4400 BAYOU BLVD, SUITE 51, PENSACOLA, FL, 325032673, US | |||||||||||||||||||||||||
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| Phone | +1 850-484-2608 |
| Fax | 8504842875 |
Authorized person
| Name | DR. JOHN F. DUFFY |
| Role | PSYCHOLOGIST |
| Phone | 8504842608 |
Taxonomy
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| License Number | PY3226 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS # |
| Number | 33188 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CLINICAL PSYCHOLOGY ASSOCIATES P.A. PROFIT SHARING PLAN | 2009 | 593266033 | 2010-06-24 | CLINICAL PSYCHOLOGY ASSOCIATES P.A. | 2 | |||||||||||||||||||||||||||||||||||||||||||||
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| Administrator’s EIN | 593266033 |
| Plan administrator’s name | CLINICAL PSYCHOLOGY ASSOCIATES P.A. |
| Plan administrator’s address | 4400 BAYOU BOULEVARD, SUITE 51, PENSACOLA, FL, 32503 |
| Administrator’s telephone number | 8504842608 |
Number of participants as of the end of the plan year
| Active participants | 1 |
| Retired or separated participants receiving benefits | 0 |
| Other retired or separated participants entitled to future benefits | 0 |
| Deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 0 |
| Number of participants with account balances as of the end of the plan year | 1 |
| Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 0 |
Signature of
| Role | Plan administrator |
| Date | 2010-06-24 |
| Name of individual signing | JOHN DUFFY |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| DUFFY, JOHN F | Agent | 4400 BAYOU BLVD., BLDG. 51, PENSACOLA, FL 32503 |
| Name | Role | Address |
|---|---|---|
| DUFFY, JOHN F. | President | 4400 BAYOU BLVD #51, PENSACOLA, FL 32503 |
| Name | Role | Address |
|---|---|---|
| DUFFY, JOHN F. | Vice President | 4400 BAYOU BLVD #51, PENSACOLA, FL 32503 |
| Name | Role | Address |
|---|---|---|
| DUFFY, JOHN F. | Treasurer | 4400 BAYOU BLVD #51, PENSACOLA, FL 32503 |
| Name | Role | Address |
|---|---|---|
| DUFFY, JOHN F. | Secretary | 4400 BAYOU BLVD #51, PENSACOLA, FL 32503 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-01-18 | 4400 BAYOU BLVD.,, BLDG # 51, PENSACOLA, FL 32503 | No data |
| CHANGE OF MAILING ADDRESS | 2012-01-18 | 4400 BAYOU BLVD.,, BLDG # 51, PENSACOLA, FL 32503 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2015-01-16 |
| ANNUAL REPORT | 2014-01-12 |
| ANNUAL REPORT | 2013-01-24 |
| ANNUAL REPORT | 2012-01-18 |
| ANNUAL REPORT | 2011-04-01 |
| ANNUAL REPORT | 2010-04-13 |
| ANNUAL REPORT | 2009-04-10 |
| ANNUAL REPORT | 2008-01-04 |
| ANNUAL REPORT | 2007-01-03 |
| ANNUAL REPORT | 2006-04-08 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
