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TIA BRAXTON, APRN, PMHNP-BC P.L.L.C.

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Company Details

Name: TIA BRAXTON, APRN, PMHNP-BC P.L.L.C.
Legal type: Kentucky Limited Liability Company
Status: Active
Standing: Good
Profit or Non-Profit: Profit
File Date: 19 Oct 2022 (3 years ago)
Organization Date: 19 Oct 2022 (3 years ago)
Last Annual Report: 13 Aug 2024 (a year ago)
Managed By: Managers
Organization Number: 1237692
ZIP code: 40228
City: Louisville, Hollow Creek, Spring Mill
Primary County: Jefferson County
Principal Office: 6540 Outer Loop Ste 6, Louisville, KY 40228
Place of Formation: KENTUCKY

Manager

Name Role
TIA PATRICE BRAXTON Manager

Registered Agent

Name Role
Tia Braxton Registered Agent

Organizer

Name Role
Tia Braxton Organizer

National Provider Identifier

NPI Number:
1134821945
Certification Date:
2023-12-04

Authorized Person:

Name:
TIA PATRICE BRAXTON
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
363LP0808X - Psychiatric/Mental Health Nurse Practitioner
Is Primary:
Yes

Contacts:

Fax:
5024161493

Assumed Names

Name Status Expiration Date
Braxton Behavioral Health Group Active 2028-11-24

Filings

Name File Date
Annual Report 2024-08-13
Certificate of Assumed Name 2023-11-24
Principal Office Address Change 2023-11-16
Annual Report 2023-03-22
Principal Office Address Change 2023-03-22

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Sources: Kentucky Secretary of State