| Name: | Sonya Broadus LPC, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 02 May 2017 (8 years ago) (Companies founded in May 2017) |
| Entity Number: | 000-390-533 |
| Register Number: | 000390533 |
| ZIP code: | 36527 (Companies in Baldwin, 36527) |
| County: | Baldwin |
| Place of Formation: | Baldwin County |
| Principal Address: | 10558 EASTERN SHORE BLVD UNIT 1012SPANISH FORT, AL 36527 |
| Authorized Capital: | 1 @ $.001/PV |
Activities
OTHER/LICENSED PROFESSIONAL COUNSELOR
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1619554623 | 2021-03-25 | 2021-03-25 | 10654 US HIGHWAY 31 STE B, SPANISH FORT, AL, 365278691, US | 10654 US HIGHWAY 31 STE B, SPANISH FORT, AL, 365278691, US | |||||||||||||||||||||||||
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| Phone | +1 251-800-1166 |
| Fax | 2513081591 |
Authorized person
| Name | MRS. KACY MARIE EAST |
| Role | OFFICE MANAGER |
| Phone | 2518001166 |
Taxonomy
| Taxonomy Code | 261QM0850X - Adult Mental Health Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 324500000X - Substance Abuse Rehabilitation Facility |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | LICENSE |
| Number | 3403 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| BROADUS, SONYA | Agent | 10654 US HIGHWAY 31 STE CSPANISH FORT, AL 36527 |
| Name | Role | Address |
|---|---|---|
| BROADUS, SONYA | Director | 10654 US HIGHWAY 31 STE CSPANISH FORT, AL 36527 |
| Name | Role | Address |
|---|---|---|
| LEGALZOOM.COM INC | Incorporator | 101 N BRAND BLVD 10TH FLOORGLENDALE, CA 91203 |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
