| Name: | Mind Body Connection Counseling, LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Revoked Entity |
| Date of Organization in Rhode Island: | 06 Sep 2021 (3 years ago) |
| Date of Dissolution: | 11 Oct 2022 (2 years ago) |
| Date of Status Change: | 11 Oct 2022 (2 years ago) |
| Identification Number: | 001728964 |
| ZIP code: | 02861 |
| County: | Providence County |
| Principal Address: | 542 CENTRAL AVE, PAWTUCKET, RI, 02861, USA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1114672250 | 2022-02-17 | 2023-02-13 | 542 CENTRAL AVE, PAWTUCKET, RI, 028615919, US | 542 CENTRAL AVE, PAWTUCKET, RI, 028615919, US | |||||||||||||||||||||
|
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| Phone | +1 401-409-5509 |
Authorized person
| Name | KATELYN MARIE CROMPTON |
| Role | THERAPIST |
| Phone | 4014095509 |
Taxonomy
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | Yes |
| Taxonomy Code | 261QM0850X - Adult Mental Health Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QM0855X - Adolescent and Children Mental Health Clinic/Center |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| KATELYN M. ANDRE | Agent | 542 CENTRAL AVE, PAWTUCKET, RI, 02861, USA |
| Number | Name | File Date |
|---|---|---|
| 202223777800 | Revocation Certificate For Failure to File the Annual Report for the Year | 2022-10-11 |
| 202219879790 | Revocation Notice For Failure to File An Annual Report | 2022-06-22 |
| 202100958010 | Articles of Organization | 2021-09-06 |
Date of last update: 28 Oct 2024
Sources: Rhode Island Department of State
