| 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 Specialists |
| 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 |
Date of last update: 17 Oct 2024
Sources: Rhode Island Department of State
