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SASHA D. FASSETT, LICENSED CLINICAL SOCIAL WORKER, P.C.

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Company Details

Name: SASHA D. FASSETT, LICENSED CLINICAL SOCIAL WORKER, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 15 Sep 2011 (14 years ago)
Entity Number: 4142410
ZIP code: 13760
County: Broome
Place of Formation: New York
Address: 217 JEFFERSON AVE, ENDICOTT, NY, United States, 13760

Shares Details

Shares issued 100

Share Par Value 0

Type NO PAR VALUE

Chief Executive Officer

Name Role Address
SASHA D. FASSETT Chief Executive Officer 217 JEFFERSON AVE, ENDICOTT, NY, United States, 13760

DOS Process Agent

Name Role Address
SASHA D. FASSETT DOS Process Agent 217 JEFFERSON AVE, ENDICOTT, NY, United States, 13760

National Provider Identifier

NPI Number:
1033457163

Authorized Person:

Name:
SASHA D FASSETT
Role:
LICENSED CLINICAL SOCIAL WORKER
Phone:

Taxonomy:

Selected Taxonomy:
1041C0700X - Clinical Social Worker
Is Primary:
Yes

Contacts:

History

Start date End date Type Value
2011-09-15 2013-09-09 Address 24 ELLIS ROAD, BINGHAMTON, NY, 13904, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
130909007218 2013-09-09 BIENNIAL STATEMENT 2013-09-01
110915000572 2011-09-15 CERTIFICATE OF INCORPORATION 2011-09-15

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Date of last update: 26 Mar 2025

Sources: New York Secretary of State