| Name: | MK Counseling and Wellness LLC |
| Jurisdiction: | Rhode Island |
| Entity type: | Foreign Limited Liability Company |
| Status: | Activ |
| Date of Organization in Rhode Island: | 17 Jul 2024 (9 months ago) |
| Branch of: | MK Counseling and Wellness LLC, CONNECTICUT (Company Number 3011181) |
| Identification Number: | 001776571 |
| Place of Formation: | CONNECTICUT |
| Principal Address: | 27 BITGOOD RD, GRISWOLD, CT, 06351, USA |
| Purpose: | TO PROVIDE BEHAVIORAL HEALTH THERAPEUTIC SERVICES AS A LICENSED INDEPENDENT CLINICAL SOCIAL WORKER (LICSW) |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1760227334 | 2024-06-26 | 2024-08-14 | 27 BITGOOD RD, GRISWOLD, CT, 063511503, US | 53 HIGH ST # A26, WESTERLY, RI, 028916027, US | |||||||||||||||||||||||
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| Phone | +1 860-576-7834 |
Authorized person
| Name | MICHELE KELLY |
| Role | OWNER |
| Phone | 8605767834 |
Taxonomy
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| Is Primary | Yes |
| Taxonomy Code | 251S00000X - Community/Behavioral Health Agency |
| Is Primary | No |
Other Provider Identifiers
| Issuer | NPI |
| Number | 1326573312 |
| State | CT |
| Name | Role | Address |
|---|---|---|
| MICHELE L KELLY | Agent | 53 HIGH ST OFFICE A 26, WESTERLY, RI, 02891, USA |
| Name | Role | Address |
|---|---|---|
| MICHELE L KELLY | MANAGER | 27 BITGOOD RD GRISWOLD, CT 06351 USA |
| Number | Name | File Date |
|---|---|---|
| 202458015230 | Application for Registration | 2024-07-17 |
Date of last update: 29 Oct 2024
Sources: Rhode Island Department of State
