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BOOMER PSYCHOLOGICAL SERVICES P.C.

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Company Details

Name: BOOMER PSYCHOLOGICAL SERVICES P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 10 Jul 2013 (12 years ago)
Entity Number: 4428777
ZIP code: 10075
County: New York
Place of Formation: New York
Address: 201 EAST 77 STREET, 16E, NEW YORK, NY, United States, 10075
Principal Address: 201 EAST 77TH STREET, APT 16E, NEW YORK, NY, United States, 10075

Shares Details

Shares issued 20000

Share Par Value 1

Type PAR VALUE

DOS Process Agent

Name Role Address
BOOMER PSYCHOLOGICAL SERVICES P.C. DOS Process Agent 201 EAST 77 STREET, 16E, NEW YORK, NY, United States, 10075

Chief Executive Officer

Name Role Address
DR BONNIE KELLEN Chief Executive Officer 201 EAST 77TH STREET, APT 16E, NEW YORK, NY, United States, 10075

National Provider Identifier

NPI Number:
1992132963

Authorized Person:

Name:
BONNIE KELLEN
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
103TC0700X - Clinical Psychologist
Is Primary:
Yes

Contacts:

History

Start date End date Type Value
2025-07-09 2025-07-09 Address 201 EAST 77TH STREET, APT 16E, NEW YORK, NY, 10075, USA (Type of address: Chief Executive Officer)
2023-08-08 2023-08-08 Address 201 EAST 77TH STREET, APT 16E, NEW YORK, NY, 10075, USA (Type of address: Chief Executive Officer)
2023-08-08 2025-07-09 Address 201 EAST 77 STREET, 16E, NEW YORK, NY, 10075, USA (Type of address: Service of Process)
2023-08-08 2025-07-09 Shares Share type: PAR VALUE, Number of shares: 20000, Par value: 1
2023-08-08 2025-07-09 Address 201 EAST 77TH STREET, APT 16E, NEW YORK, NY, 10075, USA (Type of address: Chief Executive Officer)

Filings

Filing Number Date Filed Type Effective Date
250709001777 2025-07-09 BIENNIAL STATEMENT 2025-07-09
230808000918 2023-08-08 BIENNIAL STATEMENT 2023-07-01
210707000901 2021-07-07 BIENNIAL STATEMENT 2021-07-07
191015002060 2019-10-15 BIENNIAL STATEMENT 2019-07-01
130710000151 2013-07-10 CERTIFICATE OF INCORPORATION 2013-07-10

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Date of last update: 26 Mar 2025

Sources: New York Secretary of State