| Name: | Broken To Art Counseling, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 24 Mar 2015 (10 years ago) (Companies founded in March 2015) |
| Entity Number: | 000-331-702 |
| Register Number: | 000331702 |
| Historical Names: |
Broken But Yet Healed Therapeutic Services, LLC
|
| ZIP code: | 35209 (Companies in Jefferson, 35209) |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Principal Address: | 717 CHALET DRIVEBIRMINGHAM, AL 35209 |
| Principal Mailing Address: | PO BOX 19862BIRMINGHAM, AL 35219 |
Activities
ENGAGE IN THERAPEUTIC SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1346839073 | 2021-01-17 | 2023-01-19 | 2100 SOUTHBRIDGE PKWY STE 650, BIRMINGHAM, AL, 352091317, US | 2100 SOUTHBRIDGE PKWY STE 650, BIRMINGHAM, AL, 352091317, US | |||||||||||||||||||||||||||
|
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| Phone | +1 205-206-6977 |
| Fax | 2055339265 |
Authorized person
| Name | LASHEENA DAVIS |
| Role | OWNER/PROVIDER |
| Phone | 2052066977 |
Taxonomy
| Taxonomy Code | 101YP2500X - Professional Counselor |
| Is Primary | Yes |
| Taxonomy Code | 251B00000X - Case Management Agency |
| Is Primary | No |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | No |
| Taxonomy Code | 305R00000X - Preferred Provider Organization |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| DAVIS, LASHEENA | Agent | 717 CHALET DRIVEBIRMINGHAM, AL 35209 |
| Name | Role | Address |
|---|---|---|
| DAVIS, LASHEENA | Organizer | 717 CHALET DRIVEBIRMINGHAM, AL 35209 |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 2018-05-14 | Name Change | Broken But Yet Healed Therapeutic Services, LLC | Broken To Art Counseling, LLC |
Date of last update: 03 Aug 2024
Sources: Alabama Secretary of State
