| 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: | PSYCHOLOGICAL COUNSELING |
| NAICS: | 621330 - Offices of Mental Health Practitioners (except Physicians) |
| Fictitious names: |
New England Occupational Safety and Healthcare Center (trading name, 1992-11-24 - ) |
| Historical names: |
Institute for Behavioral Sciences, Inc. |
| 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 |
| 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 |
Date of last update: 05 Oct 2024
Sources: Rhode Island Department of State
