| Name: | Dragonfly Psychological Associates LLC |
| Jurisdiction: | Kentucky |
| Profit or Non-Profit: | Profit |
| Legal type: | Kentucky Limited Liability Company |
| Status: | Active |
| Standing: | Good |
| File Date: | 29 Jun 2020 (5 years ago) |
| Organization Date: | 29 Jun 2020 (5 years ago) |
| Last Annual Report: | 11 Apr 2024 (9 months ago) |
| Managed By: | Members |
| Organization Number: | 1102071 |
| Industry: | Health Services |
| Number of Employees: | Small (0-19) |
| ZIP code: | 40059 |
| Primary County: | Jefferson |
| Principal Office: | 9403 Hobblebush St, Prospect, KY 40059 |
| Place of Formation: | KENTUCKY |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DRAGONFLY PSYCHOLOGICAL ASSOCIATES LLC CBS BENEFIT PLAN | 2022 | 851710731 | 2023-12-27 | DRAGONFLY PSYCHOLOGICAL ASSOCIATES LLC | 1 | |||||||||||||||||||||||||||||||
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| Administrator’s EIN | 846429706 |
| Plan administrator’s name | SHAWNA BURTON |
| Plan administrator’s address | 464 CHENAULT RD, FRANKFORT, KY, 40601 |
| Administrator’s telephone number | 5026954700 |
Signature of
| Role | Plan administrator |
| Date | 2023-12-27 |
| Name of individual signing | SHAWNA BURTON |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 501 |
| Effective date of plan | 2021-11-01 |
| Business code | 621491 |
| Sponsor’s telephone number | 5022307599 |
| Plan sponsor’s address | 9403 HOBBLEBUSH STREET, PROSPECT, KY, 40059 |
Plan administrator’s name and address
| Administrator’s EIN | 846429706 |
| Plan administrator’s name | SHAWNA BURTON |
| Plan administrator’s address | 464 CHENAULT RD, FRANKFORT, KY, 40601 |
| Administrator’s telephone number | 5026954700 |
Signature of
| Role | Plan administrator |
| Date | 2022-12-29 |
| Name of individual signing | SHAWNA BURTON |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role |
|---|---|
| Michael Wise | Organizer |
| Barb Beauchamp | Organizer |
| Name | Role |
|---|---|
| Barb Beauchamp | Registered Agent |
| Name | Role |
|---|---|
| Barbara Beauchamp | Member |
| Name | File Date |
|---|---|
| Annual Report | 2024-04-11 |
| Annual Report | 2023-04-06 |
| Annual Report | 2022-06-02 |
| Reinstatement Certificate of Existence | 2022-02-02 |
| Reinstatement | 2022-02-02 |
| Reinstatement Approval Letter Revenue | 2022-01-21 |
| Administrative Dissolution | 2021-10-19 |
Date of last update: 26 Nov 2024
Sources: Kentucky Secretary of State
