| Name: | WILDER THERAPY AND WELLNESS, LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Activ |
| Date of Organization in Rhode Island: | 08 Jan 2013 (12 years ago) |
| Identification Number: | 000795633 |
| ZIP code: | 02817 |
| County: | Kent County |
| Principal Address: | 134 SHARPE STREET UNIT 3, WEST GREENWICH, RI, 02817, USA |
| Purpose: | INDIVIDUAL THERAPY COUPLES COUNSELING DIAGNOSTIC AND ACADEMIC ASSESSMENT AND CONSULTATION |
NAICS
621112 Offices of Physicians, Mental Health SpecialistsThis U.S. industry comprises establishments of health practitioners having the degree of M.D. (Doctor of Medicine) or D.O. (Doctor of Osteopathy) primarily engaged in the independent practice of psychiatry or psychoanalysis. 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 | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1346664505 | 2014-02-08 | 2014-02-08 | 63 SOCKANOSSET CROSS RD, 2A-7, CRANSTON, RI, 029205557, US | 63 SOCKANOSSET CROSS RD, 2A-7, CRANSTON, RI, 029205557, US | |||||||||||||||||||||||
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| Phone | +1 401-406-1101 |
| Fax | 4017128659 |
Authorized person
| Name | MISS HEATHER N WILDER |
| Role | OWNER/ CLINICAL PSYCHOLOGIST |
| Phone | 4014061101 |
Taxonomy
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | INDIVIDUAL NPI- JAMI WILDER |
| Number | 1891125167 |
| Issuer | INDIVIDUAL NPI- HEATHER WILDER |
| Number | 1083943310 |
| Name | Role | Address |
|---|---|---|
| ORSON AND BRUSINI LTD. | Agent | 211 QUAKER LANE SUITE 201, WEST WARWICK, RI, 02893, USA |
| Number | Name | File Date |
|---|---|---|
| 202452107850 | Annual Report - Amended | 2024-04-23 |
| 202449986910 | Annual Report | 2024-04-02 |
| 202330894380 | Annual Report | 2023-03-14 |
| 202224483430 | Statement of Change of Registered/Resident Agent Office | 2022-10-21 |
| 202212974500 | Annual Report | 2022-03-16 |
| 202105516170 | Annual Report | 2021-11-29 |
| 202189973650 | Annual Report | 2021-02-04 |
| 201925255410 | Annual Report | 2019-10-24 |
| 201879669480 | Annual Report | 2018-10-17 |
| 201751897590 | Annual Report | 2017-10-19 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 7831617308 | 2020-04-30 | 0165 | PPP | 535 CENTERVILLE RD STE 302A, WARWICK, RI, 02886-4376 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 17 Oct 2024
Sources: Rhode Island Department of State
