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Phoenix Behavioral Health Center, PLLC

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Company Details

Name: Phoenix Behavioral Health Center, PLLC
Jurisdiction: MISSISSIPPI
Business Type: Limited Liability Company
Status: Good Standing
Effective Date: 22 Aug 2019 (6 years ago)
Business ID: 1186762
ZIP code: 39564
County: Jackson
State of Incorporation: MISSISSIPPI
Principal Office Address: 2112 Bienville Blvd Ste KOcean Springs, MS 39564
Historical names: Anchor Psychology Center, PLLC

Agent

Name Role Address
Kathryn K Waggoner Agent 2112 Bienville Blvd Ste K, Ocean Springs, MS 39564

Manager

Name Role Address
Kathryn K Waggoner Manager 2112 Bienville Blvd Ste K, Ocean Springs, MS 39564

President

Name Role Address
Kathryn K Waggoner President 2112 Bienville Blvd Ste K, Ocean Springs, MS 39564

National Provider Identifier

NPI Number:
1093366775
Certification Date:
2024-06-10

Authorized Person:

Name:
DR. KATHRYN KIM WAGGONER
Role:
CEO
Phone:

Taxonomy:

Selected Taxonomy:
101YP2500X - Professional Counselor
Is Primary:
No
Selected Taxonomy:
103T00000X - Psychologist
Is Primary:
No
Selected Taxonomy:
103TC0700X - Clinical Psychologist
Is Primary:
No
Selected Taxonomy:
101Y00000X - Counselor
Is Primary:
No
Selected Taxonomy:
101YM0800X - Mental Health Counselor
Is Primary:
No

Contacts:

Fax:
8337791879
Fax:
2282054986

Filings

Type Status Filed Date Description
Annual Report LLC Filed 2025-02-11 Annual Report For Phoenix Behavioral Health Center, PLLC
Annual Report LLC Filed 2024-03-07 Annual Report For Phoenix Behavioral Health Center, PLLC
Annual Report LLC Filed 2023-05-18 Annual Report For Phoenix Behavioral Health Center, PLLC
Amendment Form Filed 2023-05-17 Amendment For Phoenix Behavioral Health Center, PLLC
Agent Resignation Filed 2022-11-30 Agent Resignation For
Annual Report LLC Filed 2022-03-25 Annual Report For Phoenix Behavioral Health Center, PLLC
Annual Report LLC Filed 2021-03-08 Annual Report For Phoenix Behavioral Health Center, PLLC
Annual Report LLC Filed 2020-06-10 Annual Report For Phoenix Behavioral Health Center, PLLC
Amendment Form Filed 2019-09-19 Amendment For Anchor Psychology Center, PLLC
Formation Form Filed 2019-08-22 Formation For Anchor Psychology Center, PLLC

USAspending Awards / Financial Assistance

Date:
2021-03-20
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
90041.20
Total Face Value Of Loan:
90041.20
Date:
2020-05-21
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO PROVIDE LOANS TO RESTORE AS NEARLY AS POSSIBLE THE VICTIMS OF ECONOMIC INJURY TYPE DISASTERS TO PRE-DISASTER CONDITIONS
Obligated Amount:
0.00
Face Value Of Loan:
150000.00
Total Face Value Of Loan:
498000.00
Date:
2020-04-16
Awarding Agency Name:
Small Business Administration
Transaction Description:
ECONOMIC INJURY DISASTER GRANT
Obligated Amount:
9000.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00
Date:
2020-04-07
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
90041.20
Total Face Value Of Loan:
90041.20

Paycheck Protection Program

Date Approved:
2021-03-20
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
90041.2
Current Approval Amount:
90041.2
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
90465.5
Date Approved:
2020-04-07
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
90041.2
Current Approval Amount:
90041.2
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
90862.47

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Date of last update: 21 May 2025

Sources: Company Profile on Mississippi Secretary of State Website