| Name: | KM Counseling and Consultant Services, Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Revoked Entity |
| Date of Organization in Rhode Island: | 02 Nov 2012 (12 years ago) |
| Date of Dissolution: | 29 Jul 2021 (4 years ago) |
| Date of Status Change: | 29 Jul 2021 (4 years ago) |
| Identification Number: | 000794259 |
| ZIP code: | 02864 |
| County: | Providence County |
| Principal Address: | 515 BROAD STREET APT 2, CUMBERLAND, RI, 02864, USA |
| Purpose: | COUNSELING AND CONSULTING SERVICES Title: 7-1.2-1701 |
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 | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1912241811 | 2012-11-15 | 2012-11-15 | 10 NATE WHIPPLE HWY, BUD BLDG. 2ND FLOOR, CUMBERLAND, RI, 028641415, US | 10 NATE WHIPPLE HWY, BUD BLDG. 2ND FLOOR, CUMBERLAND, RI, 028641415, US | |||||||||||||||||||
|
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| Phone | +1 401-658-6448 |
| Fax | 4016580100 |
Authorized person
| Name | KIM M MEDEIROS |
| Role | PRESIDENT |
| Phone | 4016586448 |
Taxonomy
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| License Number | MHC00198 |
| State | RI |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MONICA HORAN, ESQ. | Agent | 393 ARMISTICE BOULEVARD, PAWTUCKET, RI, 02861, USA |
| Name | Role | Address |
|---|---|---|
| KIM M MEDEIROS CANNATA | PRESIDENT | 44 BRYANT STREET CUMBERLAND, RI 02864 USA |
| Number | Name | File Date |
|---|---|---|
| 202199691380 | Revocation Certificate For Failure to File the Annual Report for the Year | 2021-07-29 |
| 202196893570 | Revocation Notice For Failure to File An Annual Report | 2021-05-19 |
| 202034198630 | Annual Report | 2020-02-11 |
| 201987961960 | Annual Report | 2019-02-27 |
| 201859384550 | Annual Report | 2018-02-28 |
| 201734930010 | Annual Report | 2017-02-24 |
| 201692624860 | Annual Report | 2016-02-16 |
| 201557450980 | Annual Report | 2015-03-12 |
| 201437110700 | Annual Report | 2014-01-28 |
| 201314619960 | Annual Report | 2013-03-29 |
Date of last update: 17 Oct 2024
Sources: Rhode Island Department of State
