| Entity Name: | JACKIE TWITCHELL, PSY.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 08 Mar 1996 (29 years ago) |
| Date of dissolution: | 27 Sep 2013 (11 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2013 (11 years ago) |
| Document Number: | P96000022406 |
| FEI/EIN Number | 650649592 |
| Address: | 8192 COLLEGE PKWY, BLDG A STE 21, FT. MYERS, FL, 33919 |
| Mail Address: | 87 CHARLOTTE DR, EAST GREENWICH, RI, 02818 |
| ZIP code: | 33919 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1750681268 | 2010-10-31 | 2010-12-02 | 8192 COLLEGE PKWY, BLDG A, STE 21, FORT MYERS, FL, 339195175, US | 8192 COLLEGE PKWY, BLDG A, STE 21, FORT MYERS, FL, 339195175, US | |||||||||||||||||||
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| Phone | +1 239-275-9353 |
| Fax | 2394663390 |
Authorized person
| Name | DR. JACKIE A TWITCHELL |
| Role | PRESIDENT |
| Phone | 2392759353 |
Taxonomy
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| License Number | PY5030 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| TWITCHELL JACKIE | Agent | 8192 COLLEGE PKWY, FT. MYERS, FL, 33919 |
| Name | Role | Address |
|---|---|---|
| TWITCHELL JACKIE | President | 8192 COLLEGE PKWY, A-21, FT MYERS, FL, 33919 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2013-09-27 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2012-04-01 | 8192 COLLEGE PKWY, BLDG A STE 21, FT. MYERS, FL 33919 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2004-03-09 | 8192 COLLEGE PKWY, BLDG A STE 21, FT. MYERS, FL 33919 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2004-03-09 | 8192 COLLEGE PKWY, BLDG A STE 21, FT. MYERS, FL 33919 | No data |
| REGISTERED AGENT NAME CHANGED | 2001-01-20 | TWITCHELL, JACKIE | No data |
| NAME CHANGE AMENDMENT | 2000-04-28 | JACKIE TWITCHELL, PSY.D., P.A. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2012-04-01 |
| ANNUAL REPORT | 2011-02-03 |
| ANNUAL REPORT | 2010-02-11 |
| ANNUAL REPORT | 2009-03-18 |
| ANNUAL REPORT | 2008-01-08 |
| ANNUAL REPORT | 2007-07-04 |
| ANNUAL REPORT | 2006-02-27 |
| ANNUAL REPORT | 2005-03-17 |
| ANNUAL REPORT | 2004-03-09 |
| ANNUAL REPORT | 2003-02-03 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
