| Name: | Broadway Psychotherapy, Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 13 Dec 2000 (24 years ago) |
| Identification Number: | 000115729 |
| ZIP code: | 02909 |
| County: | Providence County |
| Principal Address: | 433 BROADWAY 2ND FL, PROVIDENCE, RI, 02909, USA |
| Purpose: | TO PROVIDE PSYCHOTHERAPY SERVICES TO PATIENTS AND SUPERVISION TO OTHER CLINICIANS. TO PROVIDE BEHAVIORAL SCIENCE CONSULTING SERVICES TO BUSINESSES. |
| Fictitious names: |
Health Behavior Consultants (trading name, 2017-08-08 - ) |
| Historical names: |
Health Behavior Consultants, Inc. |
NAICS
621420 Outpatient Mental Health and Substance Abuse CentersThis industry comprises establishments with medical staff primarily engaged in providing outpatient services related to the diagnosis and treatment of mental health disorders and alcohol and other substance abuse. These establishments generally treat patients who do not require inpatient treatment. They may provide a counseling staff and information regarding a wide range of mental health and substance abuse issues and/or refer patients to more extensive treatment programs, if necessary. Learn more at the U.S. Census Bureau
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1811162316 | 2008-04-25 | 2017-05-03 | 347 BROADWAY, PROVIDENCE, RI, 029091101, US | 347 BROADWAY, PROVIDENCE, RI, 029091101, US | |||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||
| Phone | +1 401-270-9808 |
| Fax | 4013547455 |
Authorized person
| Name | DR. JEFFREY P. MIGNEAULT |
| Role | PRESIDENT |
| Phone | 4012709808 |
Taxonomy
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| License Number | PS00585 |
| State | RI |
| Is Primary | Yes |
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| License Number | ISW00174 |
| State | RI |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| JEFFREY MIGNEAULT | Agent | 35 STEERE ROAD, GREENVILLE, RI, 02828, USA |
| Name | Role | Address |
|---|---|---|
| JEFFREY MIGNEAULT | PRESIDENT | 433 BROADWAY PROVIDENCE, RI 02909 USA |
| Name | Role | Address |
|---|---|---|
| SARAH TORREY | VICE PRESIDENT | 433 BROADWAY PROVIDENCE, RI 02909 USA |
| Type | Date | Old Value | New Value |
|---|---|---|---|
| Name Change | 2017-05-01 | Health Behavior Consultants, Inc. | Broadway Psychotherapy, Inc. |
| Number | Name | File Date |
|---|---|---|
| 202455060710 | Annual Report | 2024-05-30 |
| 202338828350 | Annual Report | 2023-06-28 |
| 202338049250 | Revocation Notice For Failure to File An Annual Report | 2023-06-19 |
| 202212680320 | Annual Report | 2022-03-12 |
| 202191591390 | Annual Report | 2021-02-17 |
| 202035890290 | Annual Report | 2020-03-04 |
| 201988783020 | Annual Report | 2019-03-18 |
| 201858899460 | Annual Report | 2018-02-23 |
| 201748289300 | Fictitious Business Name Statement | 2017-08-08 |
| 201742355290 | Articles of Amendment | 2017-05-01 |
Date of last update: 10 Apr 2025
Sources: Rhode Island Department of State
