| Name: | Fortunato Psychology Services, LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Revoked Entity |
| Date of Organization in Rhode Island: | 08 Feb 2016 (9 years ago) |
| Date of Dissolution: | 14 Feb 2022 (3 years ago) |
| Date of Status Change: | 14 Feb 2022 (3 years ago) |
| Identification Number: | 001660272 |
| ZIP code: | 02906 |
| County: | Providence County |
| Principal Address: | 1 RICHMOND SQUARE SUITE 217W, PROVIDENCE, RI, 02906, USA |
| Mailing Address: | 1 RICHMOND SQUARE SUITE 217W, PROVIDENCE, RI, 02906, US |
| Purpose: | CLINICAL PSYCHOLOGY PRACTICE TREATING INDIVIDUALS, COUPLES AND FAMILIES WITH DIVERSE PRESENTING CONCERNS. |
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 | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1578921185 | 2016-02-10 | 2016-02-10 | 1 RICHMOND SQ, SUITE 217 W, PROVIDENCE, RI, 029065139, US | 1 RICHMOND SQ, SUITE 217 W, PROVIDENCE, RI, 029065139, US | |||||||||||||||||
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| Phone | +1 401-489-3636 |
Authorized person
| Name | DR. JESSICA VICTORIA FORTUNATO |
| Role | CLINICAL PSYCHOLOGIST |
| Phone | 4014893636 |
Taxonomy
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| License Number | PS00986 |
| State | RI |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| JESSICA V. FORTUNATO, PSY.D. | Agent | 1 RICHMOND SQUARE SUITE 217W, PROVIDENCE, RI, 02906, USA |
| Number | Name | File Date |
|---|---|---|
| 202210312250 | Revocation Certificate For Failure to File the Annual Report for the Year | 2022-02-14 |
| 202106537020 | Revocation Notice For Failure to File An Annual Report | 2021-12-03 |
| 202187777980 | Annual Report | 2021-01-26 |
| 201926252760 | Annual Report | 2019-10-30 |
| 201883429410 | Annual Report | 2018-12-31 |
| 201748937120 | Annual Report | 2017-08-30 |
| 201692018830 | Articles of Organization | 2016-02-08 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 2557677210 | 2020-04-16 | 0165 | PPP | 1 Richmond Sq Suite 217W, Providence, RI, 02906 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 26 Oct 2024
Sources: Rhode Island Department of State
