| 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)This industry comprises establishments of independent mental health practitioners (except physicians) primarily engaged in (1) the diagnosis and treatment of mental, emotional, and behavioral disorders and/or (2) the diagnosis and treatment of individual or group social dysfunction brought about by such causes as mental illness, alcohol and substance abuse, physical and emotional trauma, or stress. These practitioners operate private or group practices in their own offices (e.g., centers, clinics) or in the facilities of others, such as hospitals or HMO medical centers. Learn more at the U.S. Census Bureau
| 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
