| Name: | RIVERSIDE COUNSELING CENTER LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Activ |
| Date of Organization in Rhode Island: | 08 May 2012 (13 years ago) |
| Identification Number: | 000790128 |
| ZIP code: | 02915 |
| County: | Providence County |
| Principal Address: | 205 BULLOCKS POINT AVENUE, RIVERSIDE, RI, 02915, USA |
| Purpose: | COUNSELING SERVICES BEHAVIORAL HEALTH |
| NAICS: | 621330 - Offices of Mental Health Practitioners (except Physicians) |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1629471446 | 2014-10-07 | 2014-10-07 | 205 BULLOCKS POINT AVE, SUITE 205 B, RIVERSIDE, RI, 029155336, US | 205 BULLOCKS POINT AVE, SUITE 205 B, RIVERSIDE, RI, 029155336, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 401-270-7379 |
| Fax | 4012701824 |
Authorized person
| Name | MS. PATRICIA A AREL |
| Role | CEO/OWNER |
| Phone | 4012707379 |
Taxonomy
| Taxonomy Code | 101YA0400X - Addiction (Substance Use Disorder) Counselor |
| License Number | CDP00290 |
| State | RI |
| Is Primary | No |
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| License Number | MHC00181 |
| State | RI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | PA32211 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| PATRICIA A. AREL | Agent | 205 BULLOCKS POINT AVENUE, RIVERSIDE, RI, 02915, USA |
| Number | Name | File Date |
|---|---|---|
| 202458902710 | Annual Report | 2024-08-19 |
| 202456238640 | Revocation Notice For Failure to File An Annual Report | 2024-06-18 |
| 202339326350 | Annual Report | 2023-07-10 |
| 202337088520 | Revocation Notice For Failure to File An Annual Report | 2023-06-16 |
| 202221160550 | Annual Report | 2022-07-12 |
| 202218964820 | Revocation Notice For Failure to File An Annual Report | 2022-06-22 |
| 202102681510 | Annual Report | 2021-10-05 |
| 202057019710 | Annual Report | 2020-09-22 |
| 201925941250 | Annual Report | 2019-10-28 |
| 201879445840 | Annual Report | 2018-10-15 |
Date of last update: 17 Oct 2024
Sources: Rhode Island Department of State
