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  5. ANGELL STREET PSYCHIATRY, LTD.

ANGELL STREET PSYCHIATRY, LTD.

Company Details

Name: ANGELL STREET PSYCHIATRY, LTD.
Jurisdiction: Rhode Island
Entity type: Domestic Profit Corporation
Status: Activ
Date of Organization in Rhode Island: 05 Nov 1992 (32 years ago)
Identification Number: 000070153
ZIP code: 02886
County: Kent County
Principal Address: 33 COLLEGE HILL RD, WARWICK, RI, 02886, USA
Purpose: PSYCHIATRY OFFICE
NAICS: 621330 - Offices of Mental Health Practitioners (except Physicians)

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1114011756 2006-10-03 2021-01-14 33 COLLEGE HILL RD, BLD 29C, WARWICK, RI, 028862776, US 33 COLLEGE HILL RD, BLD 29C, WARWICK, RI, 028862776, US

Contacts
Phone +1 401-822-4673
Fax 4018224676

Authorized person
Name DR. DAVID E KROESSLER
Role PRESIDENT/OWNER
Phone 4018224673

Taxonomy
Taxonomy Code 103T00000X - Psychologist
Is Primary No
Taxonomy Code 104100000X - Social Worker
Is Primary No
Taxonomy Code 163WP0808X - Psychiatric/Mental Health Registered Nurse
Is Primary No
Taxonomy Code 207QA0401X - Addiction Medicine (Family Medicine) Physician
Is Primary No
Taxonomy Code 2084P0800X - Psychiatry Physician
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ANGELL STREET PSYCHIATRY 401(K) PLAN 2014 050468084 2015-10-13 ANGELL STREET PSYCHIATRY, LTD 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621112
Sponsor’s telephone number 4018842008
Plan sponsor’s address 1351 SOUTH COUNTY TRIAL BLDG 2, 210, E. GREENWICH, RI, 02818

Plan administrator’s name and address
Administrator’s EIN 050468084
Plan administrator’s name ANGELL STREET PSYCHIATRY, LTD
Plan administrator’s address 1351 SOUTH COUNTY TRIAL BLDG 2, 210, E. GREENWICH, RI, 02818
Administrator’s telephone number 4018842008

Signature of
Role Plan administrator
Date 2015-10-13
Name of individual signing DR. DAVID KROESSLER
Valid signature Filed with authorized/valid electronic signature
ANGELL STREET PSYCHIATRY 401(K) PLAN 2013 050468084 2014-10-14 ANGELL STREET PSYCHIATRY, LTD 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621112
Sponsor’s telephone number 4018842008
Plan sponsor’s address 1351 SOUTH COUNTY TRIAL BLDG 2, 210, E. GREENWICH, RI, 02818

Plan administrator’s name and address
Administrator’s EIN 050468084
Plan administrator’s name ANGELL STREET PSYCHIATRY, LTD
Plan administrator’s address 1351 SOUTH COUNTY TRIAL BLDG 2, 210, E. GREENWICH, RI, 02818
Administrator’s telephone number 4018842008

Signature of
Role Plan administrator
Date 2014-10-14
Name of individual signing DR. DAVID KROESSLER
Valid signature Filed with authorized/valid electronic signature
ANGELL STREET PSYCHIATRY 401(K) PLAN 2012 050468084 2013-09-13 ANGELL STREET PSYCHIATRY, LTD 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621112
Sponsor’s telephone number 4018842008
Plan sponsor’s address 1351 SOUTH COUNTY TRIAL BLDG 2, 210, E. GREENWICH, RI, 02818

Plan administrator’s name and address
Administrator’s EIN 050468084
Plan administrator’s name ANGELL STREET PSYCHIATRY, LTD
Plan administrator’s address 1351 SOUTH COUNTY TRIAL BLDG 2, 210, E. GREENWICH, RI, 02818
Administrator’s telephone number 4018842008

Signature of
Role Plan administrator
Date 2013-09-13
Name of individual signing DR. DAVID KROESSLER
Valid signature Filed with authorized/valid electronic signature
ANGELL STREET PSYCHIATRY 401(K) PLAN 2011 050468084 2012-06-06 ANGELL STREET PSYCHIATRY, LTD 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621112
Sponsor’s telephone number 4018842008
Plan sponsor’s address 1351 SOUTH COUNTY TRIAL BLDG 2, 210, E. GREENWICH, RI, 02818

Plan administrator’s name and address
Administrator’s EIN 050468084
Plan administrator’s name ANGELL STREET PSYCHIATRY, LTD
Plan administrator’s address 1351 SOUTH COUNTY TRIAL BLDG 2, 210, E. GREENWICH, RI, 02818
Administrator’s telephone number 4018842008

Signature of
Role Plan administrator
Date 2012-06-06
Name of individual signing DR. DAVID KROESSLER
Valid signature Filed with authorized/valid electronic signature
ANGELL STREET PSYCHIATRY 401(K) PLAN 2010 050468084 2012-04-09 ANGELL STREET PSYCHIATRY, LTD 12
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621112
Sponsor’s telephone number 4018842008
Plan sponsor’s address 1351 SOUTH COUNTY TRIAL BLDG 2, 210, E. GREENWICH, RI, 02818

Plan administrator’s name and address
Administrator’s EIN 050468084
Plan administrator’s name ANGELL STREET PSYCHIATRY, LTD
Plan administrator’s address 1351 SOUTH COUNTY TRIAL BLDG 2, 210, E. GREENWICH, RI, 02818
Administrator’s telephone number 4018842008

Signature of
Role Plan administrator
Date 2012-04-09
Name of individual signing DR. DAVID KROESSLER
Valid signature Filed with incorrect/unrecognized electronic signature
ANGELL STREET PSYCHIATRY 401(K) PLAN 2010 050468084 2012-04-09 ANGELL STREET PSYCHIATRY, LTD 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621112
Sponsor’s telephone number 4018842008
Plan sponsor’s address 1351 SOUTH COUNTY TRIAL BLDG 2, 210, E. GREENWICH, RI, 02818

Plan administrator’s name and address
Administrator’s EIN 050468084
Plan administrator’s name ANGELL STREET PSYCHIATRY, LTD
Plan administrator’s address 1351 SOUTH COUNTY TRIAL BLDG 2, 210, E. GREENWICH, RI, 02818
Administrator’s telephone number 4018842008

Signature of
Role Plan administrator
Date 2012-04-09
Name of individual signing DR. DAVID KROESSLER
Valid signature Filed with authorized/valid electronic signature
ANGELL STREET PSYCHIATRY 401(K) PLAN 2009 050468084 2010-10-14 ANGELL STREET PSYCHIATRY, LTD 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 621112
Sponsor’s telephone number 4018842008
Plan sponsor’s address 1351 SOUTH COUNTY TRIAL BLDG 2, 210, E. GREENWICH, RI, 02818

Plan administrator’s name and address
Administrator’s EIN 050468084
Plan administrator’s name ANGELL STREET PSYCHIATRY, LTD
Plan administrator’s address 1351 SOUTH COUNTY TRIAL BLDG 2, 210, E. GREENWICH, RI, 02818
Administrator’s telephone number 4018842008

Signature of
Role Plan administrator
Date 2010-10-14
Name of individual signing DR. DAVID KROESSLER
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
DAVID KROESSLER, MD Agent 321 HOPE STREET, PROVIDENCE, RI, 02906, USA

PRESIDENT

Name Role Address
DAVID E KROESSLER MD PRESIDENT 321 HOPE STREET PROVIDENCE, RI 02906 USA

OTHER OFFICER

Name Role Address
DAVID KROESSLER OTHER OFFICER 33 COLLEGE HILL RD WARWICK, RI 02886 UNI

Filings

Number Name File Date
202445242100 Annual Report 2024-02-01
202332719230 Annual Report 2023-04-11
202216258480 Annual Report 2022-04-29
202184110140 Annual Report 2021-01-04
202038642580 Annual Report 2020-04-23
202038642670 Annual Report 2020-04-23
202038642760 Annual Report 2020-04-23
202038642850 Annual Report 2020-04-23
202038642300 Reinstatement 2020-04-23
201752754450 Revocation Certificate For Failure to File the Annual Report for the Year 2017-11-02

Related by officers

DAVID KROESSLER

Mount Tom Club Three Angels, LLC

Related by address

33 COLLEGE HILL RD, WARWICK, RI, 02886, USA

OMIA PROPERTIES, LLC

Date of last update: 07 Oct 2024

Sources: Rhode Island Department of State

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