| Name: | Lincoln Psychiatric Services, Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 14 Jun 2002 (23 years ago) |
| Identification Number: | 000125305 |
| ZIP code: | 02865 |
| County: | Providence County |
| Principal Address: | 652 GEORGE WASHINGTON HIGHWAY, LINCOLN, RI, 02865, USA |
| Purpose: | PSYCHIATRIC SERVICES PHYSICIAN OFFICE |
| NAICS: | 621112 - Offices of Physicians, Mental Health Specialists |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1194943845 | 2007-04-20 | 2010-09-16 | 652 GEORGE WASHINGTON HWY, SUITE 400, LINCOLN, RI, 028654267, US | 652 GEORGE WASHINGTON HWY, SUITE 400, LINCOLN, RI, 028654267, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 401-334-1830 |
| Fax | 4013341833 |
Authorized person
| Name | DR. WALTER D FITZHUGH III |
| Role | PRESIDENT |
| Phone | 4013341830 |
Taxonomy
| Taxonomy Code | 2084A0401X - Addiction Medicine (Psychiatry & Neurology) Physician |
| License Number | MD09313 |
| State | RI |
| Is Primary | Yes |
| Taxonomy Code | 2084A0401X - Addiction Medicine (Psychiatry & Neurology) Physician |
| License Number | 78755 |
| State | MA |
| Is Primary | No |
| Taxonomy Code | 364SP0809X - Adult Psychiatric/Mental Health Clinical Nurse Specialist |
| License Number | PPNS00043 |
| State | RI |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| WALTER D. FITZHUGH, III MD | Agent | 652 GEORGE WASHINGTON HIGHWAY SUITE 400, LINCOLN, RI, 02865, USA |
| Name | Role | Address |
|---|---|---|
| WALTER D. FITZHUGH II MD | PRESIDENT | 10 SEAVIEW DRIVE BARRINGTON, RI 02816 USA |
| Number | Name | File Date |
|---|---|---|
| 202453997810 | Annual Report | 2024-05-07 |
| 202327341150 | Annual Report - Amended | 2023-02-02 |
| 202327339850 | Annual Report | 2023-02-02 |
| 202209093270 | Annual Report | 2022-02-01 |
| 202196051970 | Annual Report | 2021-04-28 |
| 202040493880 | Annual Report | 2020-05-19 |
| 201986941350 | Annual Report | 2019-02-19 |
| 201863133070 | Annual Report | 2018-04-30 |
| 201863133160 | Annual Report | 2018-04-30 |
| 201863132730 | Reinstatement | 2018-04-30 |
Date of last update: 09 Oct 2024
Sources: Rhode Island Department of State
