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Mind Body Connection Counseling, LLC

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Company Details

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 (4 years ago)
Date of Dissolution: 11 Oct 2022 (3 years ago)
Date of Status Change: 11 Oct 2022 (3 years ago)
Identification Number: 001728964
ZIP code: 02861
County: Providence County
Principal Address: Google Maps Logo 542 CENTRAL AVE, PAWTUCKET, RI, 02861, USA

Agent

Name Role Address
KATELYN M. ANDRE Agent 542 CENTRAL AVE, PAWTUCKET, RI, 02861, USA

National Provider Identifier

NPI Number:
1114672250
Certification Date:
2023-02-13

Authorized Person:

Name:
KATELYN MARIE CROMPTON
Role:
THERAPIST
Phone:

Taxonomy:

Selected Taxonomy:
261QM0850X - Adult Mental Health Clinic/Center
Is Primary:
No
Selected Taxonomy:
261QM0855X - Adolescent and Children Mental Health Clinic/Center
Is Primary:
No
Selected Taxonomy:
261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center)
Is Primary:
Yes

Contacts:

Filings

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

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Date of last update: 05 Jun 2025

Sources: Rhode Island Department of State