| Name: | Gwen Kolb, LICSW, LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Activ |
| Date of Organization in Rhode Island: | 18 Feb 2022 (3 years ago) |
| Identification Number: | 001736372 |
| ZIP code: | 02903 |
| County: | Providence County |
| Principal Address: | 275 WICKENDEN STREET #1, PROVIDENCE, RI, 02903, USA |
| Mailing Address: | 275 WICKENDEN ST. #1, PROVIDENCE, RI, 02903, USA |
| Purpose: | PRIVATE PRACTICE - OUTPATIENT, INDIVIDUAL, PSYCHOTHERAPY (MENTAL/BEHAVIORAL HEALTH) FOR ADULTS LIVING IN RI AND MA. |
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 | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1114642592 | 2022-10-07 | 2022-10-07 | 275 WICKENDEN ST, PROVIDENCE, RI, 029034480, US | 275 WICKENDEN ST, PROVIDENCE, RI, 029034480, US | |||||||||||||
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| Phone | +1 401-321-4070 |
Authorized person
| Name | GWEN KOLB |
| Role | OWNER |
| Phone | 6172028688 |
Taxonomy
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| GWEN KOLB | Agent | 275 WICKENDEN STREET #1, PROVIDENCE, RI, 02903, USA |
| Number | Name | File Date |
|---|---|---|
| 202445506590 | Annual Report | 2024-02-04 |
| 202331344460 | Annual Report | 2023-03-22 |
| 202211235620 | Articles of Organization | 2022-02-18 |
Date of last update: 28 Oct 2024
Sources: Rhode Island Department of State
