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Psychiatry South, Inc.

Details

Name: Psychiatry South, Inc.
Jurisdiction: Alabama
Legal type: Domestic Corporation
Status: Exists
Date of registration: 22 May 2014 (11 years ago) (Companies founded in May 2014)
Entity Number: 000-310-613
Register Number: 000310613
ZIP code: 35244 (Companies in Jefferson, 35244)
County: Jefferson
Place of Formation: Shelby County
Registered Office Street Address: 200 CHASE PARK SOUTH SUITE 102BIRMINGHAM, AL 35244
Authorized Capital: 1000 @ $1 PV

Activities MENTAL HEALTH CLINIC W/PHYCHIATRISTS/PSYCHOLOGISTS/SOCIALWORKERS

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1144764796 2016-12-15 2016-12-15 3000 SOUTHLAKE PARK, SUITE 100, HOOVER, AL, 352443293, US 3000 SOUTHLAKE PARK, SUITE 100, HOOVER, AL, 352443293, US

Contacts
Phone +1 205-987-0724
Fax 2059870725

Authorized person
Name DR. EMILY HAMILTON LAZENBY
Role OWNER/PARTNER
Phone 2059870724

Taxonomy
Taxonomy Code 363LP0808X - Psychiatric/Mental Health Nurse Practitioner
License Number 1-131966
State AL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PSYCHIATRY SOUTH, INC. 401K PLAN 2023 270409294 2024-06-25 PSYCHIATRY SOUTH, INC. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621112
Sponsor’s telephone number 2059870724
Plan sponsor’s address 3000 SOUTHLAKE PARK, SUITE 100, BIRMINGHAM, AL, 35244

Signature of
Role Plan administrator
Date 2024-06-25
Name of individual signing KRISTIN POPE
PSYCHIATRY SOUTH, INC. 401K PLAN 2022 270409294 2023-09-19 PSYCHIATRY SOUTH, INC. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621112
Sponsor’s telephone number 2059870724
Plan sponsor’s address 3000 SOUTHLAKE PARK, SUITE 100, BIRMINGHAM, AL, 35244

Signature of
Role Plan administrator
Date 2023-09-19
Name of individual signing KRISTIN POPE
PSYCHIATRY SOUTH, INC. 401K PLAN 2021 270409294 2022-10-10 PSYCHIATRY SOUTH, INC. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621112
Sponsor’s telephone number 2059870724
Plan sponsor’s address 3000 SOUTHLAKE PARK, SUITE 100, BIRMINGHAM, AL, 35244

Signature of
Role Plan administrator
Date 2022-10-10
Name of individual signing KRISTIN POPE
PSYCHIATRY SOUTH, INC. 401K PLAN 2020 270409294 2021-10-12 PSYCHIATRY SOUTH, INC. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621112
Sponsor’s telephone number 2059870724
Plan sponsor’s address 3000 SOUTHLAKE PARK, SUITE 100, BIRMINGHAM, AL, 35244

Signature of
Role Plan administrator
Date 2021-10-12
Name of individual signing KRISTIN POPE
PSYCHIATRY SOUTH, INC. 401K PLAN 2019 270409294 2020-10-06 PSYCHIATRY SOUTH, INC. 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621112
Sponsor’s telephone number 2059870724
Plan sponsor’s address 3000 SOUTHLAKE PARK, SUITE 100, BIRMINGHAM, AL, 35244

Signature of
Role Plan administrator
Date 2020-10-06
Name of individual signing KRISTIN POPE
PSYCHIATRY SOUTH, INC. 401(K) PLAN 2018 270409294 2019-10-14 PSYCHIATRY SOUTH, INC. 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621112
Sponsor’s telephone number 2059870724
Plan sponsor’s address 3000 SOUTHLAKE PARK, SUITE 100, HOOVER, AL, 352441865

Signature of
Role Plan administrator
Date 2019-10-14
Name of individual signing EMILY LAZENBY
PSYCHIATRY SOUTH, INC. 401(K) PLAN 2017 270409294 2018-07-17 PSYCHIATRY SOUTH, INC. 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621112
Sponsor’s telephone number 2059870724
Plan sponsor’s address 3000 SOUTHLAKE PARK, SUITE 100, HOOVER, AL, 352441865

Signature of
Role Plan administrator
Date 2018-07-17
Name of individual signing EMILY LAZENBY
PSYCHIATRY SOUTH, INC. 401(K) PLAN 2016 270409294 2017-09-26 PSYCHIATRY SOUTH, INC. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621112
Sponsor’s telephone number 2059870724
Plan sponsor’s address 3000 SOUTHLAKE PARK, SUITE 100, BIRMINGHAM, AL, 352441865

Signature of
Role Plan administrator
Date 2017-09-26
Name of individual signing EMILY LAZENBY
PSYCHIATRY SOUTH, INC. 401(K) PLAN 2015 270409294 2016-08-03 PSYCHIATRY SOUTH, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621112
Sponsor’s telephone number 2059870724
Plan sponsor’s address 3000 SOUTHLAKE PARK, SUITE 100, HOOVER, AL, 352441865
PSYCHIATRY SOUTH, INC. 401(K) PLAN 2014 270409294 2015-07-10 PSYCHIATRY SOUTH, INC. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621112
Sponsor’s telephone number 2059870724
Plan sponsor’s address 3000 SOUTHLAKE PARK, SUITE 100, BIRMINGHAM, AL, 352441865

Signature of
Role Plan administrator
Date 2015-07-10
Name of individual signing EMILY LAZENBY

Agent

Name Role Address
JONES, REBECCA W Agent 4917 MOUNTAIN VIEW PARKWAYBIRMINGHAM, AL 35244

Director

Name Role Address
JONES, REBECCA WORRELL Director 4917 MOUNTAIN VIEW PARKWAYBIRMINGHAM, AL 35244
LAZENBY, EMILY HAMILTON Director 2444 SHADES CREST ROADBIRMINGHAM, AL 35216
AUSTIN, ALICIA HINDELANG Director 601 O'NEAL DRIVEBIRMINGHAM, AL 35226

Incorporator

Name Role Address
JONES, REBECCA W Incorporator 4917 MOUNTAIN VIEW PARKWAYBIRMINGHAM, AL 35244
LAZENBY, EMILY H Incorporator 1789 VESTAVIA LANEBIRMINGHAM, AL 35216
AUSTIN, ALICIA H Incorporator 601 O'NEAL DRIVEBIRMINGHAM, AL 35226

Related by officers

LAZENBY, EMILY HAMILTON

MedPlex Inc.

LAZENBY, EMILY H

MedPlex Inc.

Related by address

200 CHASE PARK SOUTH SUITE 102BIRMINGHAM, AL 35244

Positive Change, L.L.C. E.R.A. Group, L.L.C. E.R.A. Real Estate LLC

Date of last update: 02 Aug 2024

Sources: Alabama Secretary of State

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