| 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 |
| NAICS: | 621112 - Offices of Physicians, Mental Health Specialists |
| Fictitious names: |
The Weight and Wellness Institute (trading name, 2022-07-28 - ) |
| 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
