| Name: | Plaza Psychology and Psychiatry, Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 26 Mar 2002 (23 years ago) |
| Identification Number: | 000123816 |
| ZIP code: | 02895 |
| County: | Providence County |
| Principal Address: | 191 SOCIAL STREET SUITE 102, WOONSOCKET, RI, 02895, USA |
| Purpose: | TO RENDER PSYCHOLOGICAL, PSYCHIATRIC AND RELATED SERVICES |
| NAICS: | 621330 - Offices of Mental Health Practitioners (except Physicians) |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1306890546 | 2006-05-20 | 2015-12-29 | 68 CUMBERLAND ST, SUITE 102, WOONSOCKET, RI, 028953323, US | 68 CUMBERLAND ST, SUITE 102, WOONSOCKET, RI, 028953323, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 401-356-1940 |
| Fax | 4013561949 |
Authorized person
| Name | PENELOPE A. YANNI |
| Role | MEDICAL DIRECTOR |
| Phone | 4013561940 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | No |
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| Is Primary | Yes |
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| Is Primary | No |
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | No |
Other Provider Identifiers
| Issuer | BEACON |
| Number | 1028940 |
| State | RI |
| Issuer | UNITED HEALTHCARE |
| Number | 1306890546 |
| State | RI |
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | 1306890546 |
| State | RI |
| Issuer | MEDICAID |
| Number | PP44291 |
| State | RI |
| Issuer | AETNA |
| Number | 9427305 |
| State | RI |
| Issuer | NEIGHBORHOOD HEALTH PLAN |
| Number | 1028940 |
| State | RI |
| Issuer | TUFT'S |
| Number | 360121 |
| State | RI |
| Issuer | RITE SHARE |
| Number | PP54298 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| LLOYD R. GARIEPY | Agent | 191 SOCIAL STREET SUITE 280, WOONSOCKET, RI, 02895, USA |
| Name | Role | Address |
|---|---|---|
| PENELOPE YANNI | PRESIDENT | 264 PRAY HILL ROAD CHEPACHET, RI 02814 USA |
| Name | Role | Address |
|---|---|---|
| NICHOLAS JOHNSON | TREASURER | 25 ANDOVER STREET APT. S1 WORCESTER , MA 01606 USA |
| Name | Role | Address |
|---|---|---|
| MARY DUCHARME | SECRETARY | 68 CUMBERLAND STREET WOONSOCKET , RI 02895 USA |
| Number | Name | File Date |
|---|---|---|
| 202446526010 | Annual Report | 2024-02-15 |
| 202326912540 | Annual Report | 2023-01-30 |
| 202208809980 | Annual Report | 2022-01-28 |
| 202187565910 | Annual Report | 2021-01-22 |
| 201930875430 | Annual Report | 2019-12-31 |
| 201984877390 | Annual Report | 2019-01-22 |
| 201858082600 | Annual Report | 2018-02-12 |
| 201730817450 | Annual Report | 2017-01-25 |
| 201690831710 | Annual Report | 2016-01-19 |
| 201555107660 | Annual Report | 2015-02-16 |
Date of last update: 09 Oct 2024
Sources: Rhode Island Department of State
