| Name: | Dmitry Meyerson, Ph. D., LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Activ |
| Date of Organization in Rhode Island: | 23 Dec 2020 (4 years ago) |
| Identification Number: | 001716709 |
| ZIP code: | 02889 |
| County: | Kent County |
| Principal Address: | 177 AIRPORT ROAD, WARWICK, RI, 02889, USA |
| Purpose: | CLINICAL PSYCHOLOGY ASSESSMENT AND TREATMENT CENTER |
| NAICS: | 621330 - Offices of Mental Health Practitioners (except Physicians) |
| Fictitious names: |
Meyerson & Associates: Comprehensive Psychological Assessment & Treatment Services (CPATS) (trading name, 2023-11-15 - ) |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1639836117 | 2021-11-19 | 2021-11-19 | 177 AIRPORT RD, WARWICK, RI, 028891046, US | 177 AIRPORT RD, WARWICK, RI, 028891046, US | |||||||||||||||||||||||||
|
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| Phone | +1 401-329-2210 |
| Fax | 4013401052 |
Authorized person
| Name | DR. DMITRY MEYERSON |
| Role | CEO/OWNER |
| Phone | 4013292210 |
Taxonomy
| Taxonomy Code | 103G00000X - Clinical Neuropsychologist |
| Is Primary | No |
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | RI-1972033827 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| DMITRY MEYERSON, PH. D. | Agent | 177 AIRPORT ROAD, WARWICK, RI, 02889, USA |
| Number | Name | File Date |
|---|---|---|
| 202445360110 | Annual Report | 2024-02-02 |
| 202342768370 | Fictitious Business Name Statement | 2023-11-15 |
| 202335594050 | Annual Report | 2023-05-12 |
| 202212453410 | Annual Report | 2022-03-08 |
| 202101453550 | Annual Report | 2021-09-14 |
| 202081457410 | Articles of Organization | 2020-12-23 |
Date of last update: 28 Oct 2024
Sources: Rhode Island Department of State
