| 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 (3 years ago) |
| Date of Status Change: | 12 Oct 2022 (3 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 |
| Historical names: |
HILDA HANNAH BLOOMBERG, INC. |
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 | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 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
