| Name: | Institute for Behavioral Medicine, Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 10 May 1988 (37 years ago) |
| Identification Number: | 000012551 |
| ZIP code: | 02920 |
| County: | Providence County |
| Principal Address: | 1210 PONTIAC AVENUE 3RD FLOOR, CRANSTON, RI, 02920, USA |
| Purpose: | CONSULTING SERVICES |
| Fictitious names: |
New England Occupational Safety and Healthcare Center (trading name, 1992-11-24 - ) |
| Historical names: |
Institute for Behavioral Sciences, Inc. |
NAICS
621330 Offices of Mental Health Practitioners (except Physicians)This industry comprises establishments of independent mental health practitioners (except physicians) primarily engaged in (1) the diagnosis and treatment of mental, emotional, and behavioral disorders and/or (2) the diagnosis and treatment of individual or group social dysfunction brought about by such causes as mental illness, alcohol and substance abuse, physical and emotional trauma, or stress. These practitioners operate private or group practices in their own offices (e.g., centers, clinics) or in the facilities of others, such as hospitals or HMO medical centers. Learn more at the U.S. Census Bureau
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1649636416 | 2016-01-11 | 2016-01-11 | 1210 PONTIAC AVE, 3RD FLOOR, CRANSTON, RI, 029204490, US | 1210 PONTIAC AVE, 3RD FLOOR, CRANSTON, RI, 029204490, US | |||||||||||||||||||
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| Phone | +1 401-467-2223 |
| Fax | 4017814570 |
Authorized person
| Name | DR. MICHAEL J FOLLICK |
| Role | PRESIDENT |
| Phone | 4014672223 |
Taxonomy
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| License Number | PS00276 |
| State | RI |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| EDWARD D. FELDSTEIN, ESQ. | Agent | 10 WEYBOSSET STREET SUITE 800, PROVIDENCE, RI, 02903, USA |
| Name | Role | Address |
|---|---|---|
| MICHAEL J FOLLICK | PRESIDENT | 22 EMELINE STREET PROVIDENCE, RI 02906 USA |
| Name | Role | Address |
|---|---|---|
| LORI SCUNGIO | OTHER OFFICER | 1210 PONTIAC AVENUE, 3RD FLOOR CRANSTON, RI 02920 USA |
| Type | Date | Old Value | New Value |
|---|---|---|---|
| Name Change | 1988-05-16 | Institute for Behavioral Sciences, Inc. | Institute for Behavioral Medicine, Inc. |
| Number | Name | File Date |
|---|---|---|
| 202448344900 | Annual Report | 2024-03-12 |
| 202327769800 | Annual Report | 2023-02-07 |
| 202213245320 | Annual Report | 2022-03-22 |
| 202186070280 | Annual Report | 2021-01-14 |
| 202033339250 | Annual Report | 2020-01-29 |
| 201985661150 | Annual Report | 2019-01-31 |
| 201856783770 | Annual Report | 2018-01-25 |
| 201730892240 | Annual Report | 2017-01-26 |
| 201629223670 | Statement of Change of Registered/Resident Agent Office | 2016-12-29 |
| 201691434910 | Annual Report | 2016-01-29 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1365107302 | 2020-04-28 | 0165 | PPP | 1210 Pontiac Ave, CRANSTON, RI, 02920 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1148578401 | 2021-02-01 | 0165 | PPS | 1210 Pontiac Ave # 0, Cranston, RI, 02920-4484 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 06 Apr 2025
Sources: Rhode Island Department of State
