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JASON KELLER, PSY. D, PLLC

Company Details

Name: JASON KELLER, PSY. D, PLLC
Legal type: Kentucky Limited Liability Company
Status: Inactive
Standing: Good
Profit or Non-Profit: Profit
File Date: 28 Sep 2010 (15 years ago)
Organization Date: 28 Sep 2010 (15 years ago)
Last Annual Report: 20 Mar 2020 (5 years ago)
Managed By: Members
Organization Number: 0772347
ZIP code: 40223
City: Louisville, Anchorage, Blue Rdg Mnr, Blue Ridge Mano...
Primary County: Jefferson County
Principal Office: 800 STONE CREEK PKWY, STE. 7, LOUISVILLE, KY 40223
Place of Formation: KENTUCKY

Member

Name Role
Jason Matthew Keller Member

Organizer

Name Role
JASON M KELLER Organizer

Registered Agent

Name Role
JASON KELLER Registered Agent

National Provider Identifier

NPI Number:
1417266578

Authorized Person:

Name:
DR. JASON KELLER
Role:
DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
103G00000X - Clinical Neuropsychologist
Is Primary:
No
Selected Taxonomy:
103K00000X - Behavior Analyst
Is Primary:
No
Selected Taxonomy:
103TC2200X - Clinical Child & Adolescent Psychologist
Is Primary:
No
Selected Taxonomy:
103TC0700X - Clinical Psychologist
Is Primary:
Yes

Contacts:

Filings

Name File Date
Dissolution 2020-08-19
Annual Report 2020-03-20
Annual Report 2019-05-09
Annual Report 2018-06-04
Registered Agent name/address change 2018-06-04

Sources: Kentucky Secretary of State