| Name: | SOUTH COUNTY PSYCHIATRY LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Activ |
| Date of Organization in Rhode Island: | 21 Nov 2019 (5 years ago) |
| Identification Number: | 001702096 |
| ZIP code: | 02852 |
| County: | Washington County |
| Principal Address: | 420 SCRABBLETOWN ROAD SUITE A, NORTH KINGSTOWN, RI, 02852, USA |
| Purpose: | THE OPERATION OF A MEDICAL PRACTICE THAT PROVIDES PSYCHIATRIC SERVICES TO ITS PATIENTS |
| Fictitious names: |
The Weight and Wellness Institute (trading name, 2022-07-28 - ) |
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 | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1003454034 | 2019-12-20 | 2023-06-23 | 420 SCRABBLETOWN RD STE A, NORTH KINGSTOWN, RI, 028523638, US | 420 SCRABBLETOWN RD STE A, NORTH KINGSTOWN, RI, 028523638, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 401-268-5333 |
| Fax | 4012685330 |
Authorized person
| Name | ANTHONY L GALLO JR. |
| Role | OWNER/ PHYSICIAN |
| Phone | 4012685333 |
Taxonomy
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| Is Primary | No |
| Taxonomy Code | 103TC2200X - Clinical Child & Adolescent Psychologist |
| Is Primary | No |
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| Is Primary | No |
| Taxonomy Code | 133V00000X - Registered Dietitian |
| Is Primary | No |
| Taxonomy Code | 207RB0002X - Obesity Medicine (Internal Medicine) Physician |
| Is Primary | No |
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SOUTH COUNTY PSYCHIATRY, LLC 401(K) PLAN | 2023 | 843755178 | 2024-07-02 | SOUTH COUNTY PSYCHIATRY, LLC | 16 | |||||||||||||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-07-02 |
| Name of individual signing | ANTHONY GALLO |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2024-07-02 |
| Name of individual signing | ANTHONY GALLO |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2020-01-01 |
| Business code | 621112 |
| Sponsor’s telephone number | 4012685333 |
| Plan sponsor’s address | 420 SCRABBLETOWN ROAD, UNIT A, NORTH KINGSTOWN, RI, 02852 |
Signature of
| Role | Plan administrator |
| Date | 2023-10-10 |
| Name of individual signing | ANTHONY GALLO |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2023-10-10 |
| Name of individual signing | ANTHONY GALLO |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2020-01-01 |
| Business code | 621112 |
| Sponsor’s telephone number | 4012685333 |
| Plan sponsor’s address | 420 SCRABBLETOWN ROAD, UNIT A, NORTH KINGSTOWN, RI, 02852 |
Signature of
| Role | Plan administrator |
| Date | 2022-10-12 |
| Name of individual signing | ANTHONY GALLO |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2022-10-12 |
| Name of individual signing | ANTHONY GALLO |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2020-01-01 |
| Business code | 621112 |
| Sponsor’s telephone number | 4012685333 |
| Plan sponsor’s address | 420 SCRABBLETOWN ROAD, UNIT A, NORTH KINGSTOWN, RI, 02852 |
Signature of
| Role | Plan administrator |
| Date | 2021-09-14 |
| Name of individual signing | ANTHONY GALLO |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2021-09-14 |
| Name of individual signing | ANTHONY GALLO |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| DOMENIC A. MOSCA, JR. | Agent | 130 TOWER HILL ROAD, NORTH KINGSTOWN, RI, 02852, USA |
| Number | Name | File Date |
|---|---|---|
| 202449397770 | Annual Report | 2024-03-25 |
| 202331554670 | Annual Report | 2023-03-23 |
| 202221748460 | Fictitious Business Name Statement | 2022-07-28 |
| 202214041110 | Annual Report | 2022-03-29 |
| 202102237500 | Annual Report | 2021-09-27 |
| 202067335510 | Annual Report | 2020-10-21 |
| 201927816060 | Articles of Organization | 2019-11-21 |
Date of last update: 27 Oct 2024
Sources: Rhode Island Department of State
