| Name: | Coordinated Counseling Services, LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Activ |
| Date of Organization in Rhode Island: | 07 Oct 2009 (16 years ago) |
| Identification Number: | 000514250 |
| ZIP code: | 02830 |
| County: | Providence County |
| Principal Address: | 24 BLUFF ROAD, HARRISVILLE, RI, 02830-1935, USA |
| Mailing Address: | 24 BLUFF ROAD, HARRISVILLE, RI, 02830, USA |
| Purpose: | COUNSELING SERVICES; PSYCHOTHERAPY |
| Fictitious names: |
PresentSelf Counseling Services, LLC (trading name, 2022-05-27 - ) |
| Historical names: |
Coordinated Counseling Services, LLC PresentSelf Counseling, LLC |
NAICS
621330 Offices of Mental Health Practitioners (except Physicians)This industry comprises establishments of independent mental health practitioners (except physicians) primarily engaged in (1) the diagnosis and treatment of mental, emotional, and behavioral disorders and/or (2) the diagnosis and treatment of individual or group social dysfunction brought about by such causes as mental illness, alcohol and substance abuse, physical and emotional trauma, or stress. These practitioners operate private or group practices in their own offices (e.g., centers, clinics) or in the facilities of others, such as hospitals or HMO medical centers. Learn more at the U.S. Census Bureau
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1295029262 | 2011-06-07 | 2022-06-01 | 221 KILVERT ST, WARWICK, RI, 028861343, US | 221 KILVERT ST, WARWICK, RI, 028861343, US | |||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 401-862-1877 |
| Phone | +1 401-328-5659 |
Authorized person
| Name | MS. CARRIE RACHEL XAVIER |
| Role | PSYCHOTHERAPIST/DIRECTOR |
| Phone | 4018621877 |
Taxonomy
| Taxonomy Code | 101Y00000X - Counselor |
| Is Primary | No |
| Taxonomy Code | 101YA0400X - Addiction (Substance Use Disorder) Counselor |
| Is Primary | No |
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | Yes |
| Taxonomy Code | 101YP2500X - Professional Counselor |
| Is Primary | No |
| Taxonomy Code | 103TC1900X - Counseling Psychologist |
| Is Primary | No |
Other Provider Identifiers
| Issuer | STATE LICENSE |
| Number | MHC00375 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| MICHAEL J. BARBOZA, CPA | Agent | 24 BLUFF ROAD, HARRISVILLE, RI, 02830, USA |
| Type | Date | Old Value | New Value |
|---|---|---|---|
| Name Change | 2022-05-27 | PresentSelf Counseling, LLC | Coordinated Counseling Services, LLC |
| Name Change | 2021-10-12 | Coordinated Counseling Services, LLC | PresentSelf Counseling, LLC |
| Number | Name | File Date |
|---|---|---|
| 202455172990 | Annual Report | 2024-05-31 |
| 202336389970 | Annual Report | 2023-05-31 |
| 202218002810 | Annual Report | 2022-05-31 |
| 202218003330 | Annual Report | 2022-05-27 |
| 202218002720 | Fictitious Business Name Statement | 2022-05-27 |
| 202218002180 | Articles of Amendment | 2022-05-27 |
| 202105632870 | Annual Report | 2021-12-01 |
| 202103108700 | Articles of Amendment | 2021-10-12 |
| 202078012930 | Annual Report | 2020-11-30 |
| 201928472580 | Annual Report | 2019-11-29 |
Date of last update: 14 Oct 2024
Sources: Rhode Island Department of State
