| Name: | Authentic Change Psychotherapy, Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 03 Jan 2022 (3 years ago) |
| Identification Number: | 001733799 |
| ZIP code: | 02906 |
| County: | Providence County |
| Principal Address: | 154 WATERMAN STREET SUITE 15, PROVIDENCE, RI, 02906, USA |
| Purpose: | THE PURPOSE OF THE CORPORATION IS OPERATE A PSYCHOTHERAPY COUNSELING AND CONSULTATION BUSINESS, AND FOR ANY OTHER LAWFUL PURPOSE. |
| NAICS: | 621330 - Offices of Mental Health Practitioners (except Physicians) |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1144971342 | 2022-01-10 | 2022-01-23 | 133 GLENWOOD AVE, PAWTUCKET, RI, 028605905, US | 154 WATERMAN ST., SUITE 15, 3RD FLOOR, PROVIDENCE, RI, 02906, US | |||||||||||||
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| Phone | +1 401-489-6885 |
Authorized person
| Name | BROOKE HUMINSKI |
| Role | OWNER |
| Phone | 4014896885 |
Taxonomy
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| AMY E. STRATTON ESQ. | Agent | 4 RICHMOND SQUARE SUITE 150, PROVIDENCE, RI, 02906, USA |
| Name | Role | Address |
|---|---|---|
| BROOKE HUMINSKI | PRESIDENT | 133 GLENWOOD AVENUE PAWTUCKET, RI 02860 UNI |
| Number | Name | File Date |
|---|---|---|
| 202457592200 | Annual Report | 2024-07-03 |
| 202457294230 | Revocation Notice For Failure to File An Annual Report | 2024-06-25 |
| 202330930510 | Annual Report | 2023-03-15 |
| 202207582460 | Articles of Incorporation | 2022-01-03 |
Date of last update: 28 Oct 2024
Sources: Rhode Island Department of State
