| Name: | Formwalt & Williams, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Dissolved |
| Date of registration: | 07 Jul 1992 (32 years ago) (Companies founded in July 1992) |
| Date of dissolution: | 27 Sep 2022 |
| Entity Number: | 000-150-643 |
| Register Number: | 000150643 |
| ZIP code: | 36693 (Companies in Mobile, 36693) |
| County: | Mobile |
| Place of Formation: | Mobile County |
| Principal Address: | MOBILE, AL |
| Registered Office Street Address: | 6023 COOPER DRIVEMOBILE, AL 36693 |
| Authorized Capital: | $1,000 |
Activities
PSYCHOLOGICAL COUNSELING SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1043304835 | 2006-10-03 | 2010-09-17 | POST OFFICE BOX 850818, MOBILE, AL, 366850818, US | 7305 COTTAGE HILL ROAD, MOBILE, AL, 36695, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 251-776-1217 |
| Fax | 2517761219 |
Authorized person
| Name | MISS JOYELLE REED |
| Role | OFFICE MANAGER |
| Phone | 2517761217 |
Taxonomy
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| License Number | 504 |
| State | AL |
| Is Primary | Yes |
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| License Number | 593 |
| State | AL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | BC & BS DR ANNIE FORMWALT |
| Number | R38382 |
| Issuer | BCBS DR LUCILE T WILLIAMS |
| Number | R82618 |
| Name | Role |
|---|---|
| FORMWALT, ANNIE L PSYD | Agent |
| Name | Role |
|---|---|
| WILLIAMS, LUCILE T PSYD | Incorporator |
| FORMWALT, ANNIE L PSYD | Incorporator |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
