| Name: | Blackstone Valley Family Therapy, Ltd. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Dissolved |
| Date of Organization in Rhode Island: | 19 Feb 2004 (21 years ago) |
| Date of Dissolution: | 16 Feb 2021 (4 years ago) |
| Date of Status Change: | 16 Feb 2021 (4 years ago) |
| Identification Number: | 000138097 |
| ZIP code: | 02864 |
| County: | Providence County |
| Principal Address: | 2190 MENDON ROAD SUITE 3, CUMBERLAND, RI, 02864, USA |
| Purpose: | THE PSYCHOLOGICAL ASSESSMENT AND ALL THERAPEUTIC SERVICES ASSOCIATED THEREWITH |
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 | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1982859997 | 2008-11-19 | 2009-01-06 | PO BOX 7683, CUMBERLAND, RI, 028640897, US | 2190 MENDON RD, SUITE 3, CUMBERLAND, RI, 028643805, US | |||||||||||||||
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| Phone | +1 401-475-5500 |
| Fax | 4014755549 |
Authorized person
| Name | DR. DAVID INGLE |
| Role | OWNER |
| Phone | 4014755500 |
Taxonomy
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| DAVID W. INGLE | Agent | 2190 MENDON ROAD SUITE 3, CUMBERLAND, RI, 02864, USA |
| Name | Role | Address |
|---|---|---|
| DAVID W. INGLE | PRESIDENT | 2190 MENDON ROAD CUMBERLAND, RI 02864 USA |
| Number | Name | File Date |
|---|---|---|
| 202191472770 | Articles of Dissolution | 2021-02-16 |
| 202035083520 | Annual Report | 2020-02-25 |
| 201882839490 | Annual Report | 2018-12-18 |
| 201858701150 | Annual Report | 2018-02-21 |
| 201737182010 | Annual Report | 2017-03-02 |
| 201693083260 | Annual Report | 2016-02-24 |
| 201693057720 | Statement of Change of Registered/Resident Agent | 2016-02-24 |
| 201693057900 | Annual Report | 2016-02-24 |
| 201693058060 | Annual Report | 2016-02-24 |
| 201693057360 | Reinstatement | 2016-02-24 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 9051357703 | 2020-05-01 | 0165 | PPP | 2190 Mendon Road 3, Cumberland, RI, 02864 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 11 Apr 2025
Sources: Rhode Island Department of State
