| Name: | HILDA HANNAH BLOOMBERG, LICSW, INC. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Revoked Entity |
| Date of Organization in Rhode Island: | 25 Mar 2013 (12 years ago) |
| Date of Dissolution: | 12 Oct 2022 (2 years ago) |
| Date of Status Change: | 12 Oct 2022 (2 years ago) |
| Identification Number: | 000797620 |
| ZIP code: | 02920 |
| County: | Providence County |
| Principal Address: | 1441 PARK AVENUE, CRANSTON, RI, 02920, USA |
| Purpose: | TO PROVIDE QUALITY BEHAVORIAL HEALTH COUNSELING SERVICES IN AN OUTPATIENT SETTING TO PROMOTE OPTIMAL MENTAL HEALTH OF CHILDREN ADULTS AND FAMILIES Title: 7-1.2-1701 |
| NAICS: | 621112 - Offices of Physicians, Mental Health Specialists |
| Historical names: |
HILDA HANNAH BLOOMBERG, INC. |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1740523240 | 2013-04-03 | 2013-04-03 | 117 GLEANER CHAPEL RD, N SCITUATE, RI, 028571204, US | 117 GLEANER CHAPEL RD, N SCITUATE, RI, 028571204, US | |||||||||||||||||||
|
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| Phone | +1 401-369-1916 |
| Fax | 4016477719 |
Authorized person
| Name | MS. HILDA HANNAH BLOOMBERG |
| Role | AUTHORIZED OFFICIAL |
| Phone | 4013691916 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| License Number | ISW01403 |
| State | RI |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| FRANK MASTRATI, JR., ESQ. | Agent | 1441 PARK AVENUE, CRANSTON, RI, 02920, USA |
| Name | Role | Address |
|---|---|---|
| HILDA H. BLOOMBERG | PRESIDENT | 117 GLEANER CHAPEL ROAD NORTH SCITUATE , RI 02857 USA |
| Type | Date | Old Value | New Value |
|---|---|---|---|
| Name Change | 2013-04-05 | HILDA HANNAH BLOOMBERG, INC. | HILDA HANNAH BLOOMBERG, LICSW, INC. |
| Number | Name | File Date |
|---|---|---|
| 202223926280 | Revocation Certificate For Failure to File the Annual Report for the Year | 2022-10-12 |
| 202220141550 | Revocation Notice For Failure to File An Annual Report | 2022-06-27 |
| 202195039780 | Annual Report | 2021-03-25 |
| 202034740190 | Annual Report | 2020-02-18 |
| 201988112460 | Annual Report | 2019-03-01 |
| 201859556290 | Annual Report | 2018-02-28 |
| 201734952940 | Annual Report | 2017-02-24 |
| 201693938740 | Annual Report | 2016-03-04 |
| 201555387620 | Annual Report | 2015-02-19 |
| 201436842440 | Annual Report | 2014-02-04 |
Date of last update: 17 Oct 2024
Sources: Rhode Island Department of State
