| 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) |
| 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
