| Name: | David Formwalt, Psy.D., LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 15 Jul 2004 (20 years ago) (Companies founded in July 2004) |
| Entity Number: | 000-453-371 |
| Register Number: | 000453371 |
| ZIP code: | 36693 (Companies in Mobile, 36693) |
| County: | Mobile |
| Place of Formation: | Mobile County |
| Principal Address: | MOBILE, AL |
| Registered Office Street Address: | 6055 COOPER DRMOBILE, AL 36693 |
Activities
ANY LAWFUL ACTIVITY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1316113970 | 2008-05-05 | 2008-05-05 | PO BOX 91276, MOBILE, AL, 366911276, US | 7305 COTTAGE HILL RD, MOBILE, AL, 366952829, US | |||||||||||||||||||
|
|||||||||||||||||||||||
| Phone | +1 251-776-1217 |
| Fax | 2517761219 |
Authorized person
| Name | DR. DAVID J FORMWALT |
| Role | CLINICAL PSYCHOLOGIST |
| Phone | 2517761217 |
Taxonomy
| Taxonomy Code | 103T00000X - Psychologist |
| License Number | 1104 |
| State | AL |
| Is Primary | Yes |
| Name | Role |
|---|---|
| FORMWALT, DAVID | Agent |
| Name | Role |
|---|---|
| FORMWALT, DAVID | Member |
| Contract Type | Award or IDV Flag | PIID | Start Date | Current End Date | Potential End Date | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PURCHASE ORDER | AWARD | HSCG4811PP2N094 | 2011-03-01 | 2011-03-31 | 2011-03-31 | |||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||
| Obligated Amount | 2000.00 |
| Current Award Amount | 2000.00 |
| Potential Award Amount | 2000.00 |
Description
| Title | DV SESSIONS FY11-15 (DEBRA) DATES OF SERVICE: 3/2/11 - 5/30/11 |
| NAICS Code | 813319: OTHER SOCIAL ADVOCACY ORGANIZATIONS |
| Product and Service Codes | U099: OTHER ED & TRNG SVCS |
Recipient Details
| Recipient | DAVID FORMWALT, PSY.D., LLC |
| UEI | EBAUHTAN3NS6 |
| Recipient Address | UNITED STATES, 7305 COTTAGE HILL RD, MOBILE, MOBILE, ALABAMA, 366952829 |
| Unique Award Key | CONT_AWD_HSCG2909P3K8003_7008_-NONE-_-NONE- |
| Awarding Agency | Department of Homeland Security |
| Link | View Page |
Description
| Title | 1 ASSESSMENT @1785.00, DEBRA VOELKER. |
Recipient Details
| Recipient | DAVID FORMWALT, PSY.D., LLC |
| UEI | EBAUHTAN3NS6 |
| Legacy DUNS | 828627807 |
| Recipient Address | UNITED STATES, 7305 COTTAGE HILL RD, MOBILE, 366952829 |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
