| Name: | Phoenix Rising Centers LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Limited Liability Company |
| Status: | Activ |
| Date of Organization in Rhode Island: | 20 Jun 2022 (3 years ago) |
| Identification Number: | 001742232 |
| ZIP code: | 02879 |
| County: | Washington County |
| Principal Address: | 313 MAIN ST G, WAKEFIELD, RI, 02879, USA |
| Purpose: | PSYCHOTHERAPY PRACTICE IN THE STATE OF RHODE ISLAND. |
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 | |||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1376276832 | 2022-07-02 | 2022-10-13 | PO BOX 5, KINGSTON, RI, 028810005, US | 1 RICHMOND SQ STE 333C, PROVIDENCE, RI, 029065139, US | |||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 401-441-5834 |
| Fax | 4012108248 |
| Phone | +1 401-297-0692 |
Authorized person
| Name | MADRONE B. PHOENIX |
| Role | OWNER |
| Phone | 4014415834 |
Taxonomy
| Taxonomy Code | 101Y00000X - Counselor |
| Is Primary | No |
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| Is Primary | No |
| Taxonomy Code | 101YP2500X - Professional Counselor |
| Is Primary | No |
| Taxonomy Code | 103T00000X - Psychologist |
| Is Primary | No |
| Taxonomy Code | 103TC0700X - Clinical Psychologist |
| Is Primary | No |
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| Is Primary | Yes |
| Taxonomy Code | 106H00000X - Marriage & Family Therapist |
| Is Primary | No |
| Taxonomy Code | 363LP0808X - Psychiatric/Mental Health Nurse Practitioner |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| MADRONE PHOENIX | Agent | 1 RICHMOND SQUARE 333W, PROVIDENCE, RI, 02906, USA |
| Number | Name | File Date |
|---|---|---|
| 202453974460 | Annual Report | 2024-05-07 |
| 202327936590 | Annual Report | 2023-02-09 |
| 202218654910 | Articles of Organization | 2022-06-20 |
Date of last update: 28 Oct 2024
Sources: Rhode Island Department of State
