| Entity Name: | CENTER FOR CLINICAL & FORENSIC PSYCHOLOGY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 14 Jun 1999 (26 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 17 Jul 2009 (16 years ago) |
| Document Number: | P99000053987 |
| FEI/EIN Number | 650938004 |
| Address: | 624 W TROPICAL WAY, PLANTATION, FL, 33317 |
| Mail Address: | 624 W TROPICAL WAY, PLANTATION, FL, 33317 |
| ZIP code: | 33317 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1265459275 | 2006-07-16 | 2012-12-27 | 624 W TROPICAL WAY, PLANTATION, FL, 333173348, US | 624 W TROPICAL WAY, PLANTATION, FL, 333173348, US | |||||||||||||||||||
|
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| Phone | +1 954-584-6155 |
| Fax | 9543167553 |
Authorized person
| Name | MS. JO-ANNE BLISS |
| Role | CLINICAL DIRECTOR |
| Phone | 9545846155 |
Taxonomy
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| License Number | PY5318 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BLISS JOANNE | Agent | 624 W TROPICAL WAY, PLANTATION, FL, 33317 |
| Name | Role | Address |
|---|---|---|
| BLISS JOANNE | President | 624 W TROPICAL WAY, PLANTATION, FL, 33317 |
| Name | Role | Address |
|---|---|---|
| URTNOWSKI JEROME | Vice President | 624 W TROPICAL WAY, PLANTATION, FL, 33317 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2009-07-17 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2008-04-30 | 624 W TROPICAL WAY, PLANTATION, FL 33317 | No data |
| CHANGE OF MAILING ADDRESS | 2008-04-30 | 624 W TROPICAL WAY, PLANTATION, FL 33317 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2008-04-30 | 624 W TROPICAL WAY, PLANTATION, FL 33317 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-22 |
| ANNUAL REPORT | 2023-04-25 |
| ANNUAL REPORT | 2022-04-29 |
| ANNUAL REPORT | 2021-04-30 |
| ANNUAL REPORT | 2020-04-13 |
| ANNUAL REPORT | 2019-04-18 |
| ANNUAL REPORT | 2018-03-22 |
| ANNUAL REPORT | 2017-04-06 |
| ANNUAL REPORT | 2016-04-12 |
| ANNUAL REPORT | 2015-04-16 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
