| Name: | Mashburn Psychological Services, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 08 Feb 2016 (9 years ago) |
| Entity Number: | 000-352-614 |
| Register Number: | 000352614 |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Registered Office Street Address: | 290 DAWN'S WAYTRUSSVILLE, AL 35173 |
| Registered Office Street Address ZIP Code: | 35173 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1952760324 | 2016-02-15 | 2016-02-15 | 15 OFFICE PARK CIR, SUITE 140, MOUNTAIN BRK, AL, 352232524, US | 15 OFFICE PARK CIR, SUITE 140, MOUNTAIN BRK, AL, 352232524, US | |||||||||||||||||||
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| Phone | +1 205-286-6917 |
| Fax | 2054357618 |
Authorized person
| Name | DR. ROBERT ERIC MASHBURN |
| Role | CLINICAL PSYCHOLOGIST |
| Phone | 2052866917 |
Taxonomy
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | 1258 |
| State | AL |
| Is Primary | Yes |
| Name | Role |
|---|---|
| MASHBURN, TERRY | Agent |
| Name | Role | Address |
|---|---|---|
| LEGALZOOM.COM,INC | Organizer | 7083 HOLLYWOOD BLVD STE 180LOS ANGELES, CA 90028 |
Date of last update: 03 Aug 2024
Sources: Alabama Secretary of State
